Explaining differences in education-related inequalities in health between urban and rural areas in Mongolia.

PubMed

Dorjdagva, Javkhlanbayar; Batbaatar, Enkhjargal; Dorjsuren, Bayarsaikhan; Kauhanen, Jussi

2015-12-22

After the socioeconomic transition in 1990, Mongolia has been experiencing demographic and epidemiologic transitions; however, there is lack of evidence on socioeconomic-related inequality in health across the country. The aim of this paper is to evaluate the education-related inequalities in adult population health in urban and rural areas of Mongolia in 2007/2008. This paper used a nationwide cross-sectional data, the Household Socio-Economic Survey 2007/2008, collected by the National Statistical Office. We employed the Erreygers' concentration index to assess the degree of education-related inequality in adult health in urban and rural areas. Our results suggest that a lower education level was associated with poor self-reported health. The concentration indices of physical limitation and chronic disease were significantly less than zero in both areas. On the other hand, ill-health was concentrated among the less educated groups. The decomposition results show education, economic activity status and income were the main contributors to education-related inequalities in physical limitation and chronic disease removing age-sex related contributions. Improving accessibility and quality of education, especially for the lower socioeconomic groups may reduce socioeconomic-related inequality in health in both rural and urban areas of Mongolia.

Exploring trends in and determinants of educational inequalities in self-rated health.

PubMed

Granström, Fredrik; Molarius, Anu; Garvin, Peter; Elo, Sirkka; Feldman, Inna; Kristenson, Margareta

2015-11-01

Educational inequalities in self-rated health (SRH) in European welfare countries are documented, but recent trends in these inequalities are less well understood. We examined educational inequalities in SRH in different age groups, and the contribution of selected material, behavioural and psychosocial determinants from 2000 to 2008. Data were derived from cross-sectional surveys conducted in 2000, 2004 and 2008 including 37,478, 34,876 and 32,982 respondents, respectively, aged 25-75 in mid-Sweden. Inequalities were analysed by age-standardized and age-stratified rate ratios of poor SRH and age-standardized prevalence of determinants, and contribution of determinants by age-adjusted logistic regression. Relative educational inequalities in SRH increased among women from 2000 (rate ratio (RR) 1.70, 95% CI 1.55-1.85) to 2008 (RR 2.07, 95% CI 1.90-2.26), but were unchanged among men (RR 1.91-2.01). The increase among women was mainly due to growing inequalities in the age group 25-34 years. In 2008, significant age differences emerged with larger inequalities in the youngest compared with the oldest age group in both genders. All determinants were more prevalent in low educational groups; the most prominent were lack of a financial buffer, smoking and low optimism. Educational differences were unchanged over the years for most determinants. In all three surveys, examined determinants together explained a substantial part of the educational inequalities in SRH. Increased relative educational health inequalities among women, and persisting inequalities among men, were paralleled by unchanged, large differences in material/structural, behavioural and psychosocial factors. Interventions to reduce these inequalities need to focus on early mid-life. © 2015 the Nordic Societies of Public Health.

Occupational class inequalities in health across employment sectors: the contribution of working conditions.

PubMed

Lahelma, Eero; Laaksonen, Mikko; Aittomäki, Akseli

2009-01-01

While health inequalities among employees are well documented, their variation and determinants among employee subpopulations are poorly understood. We examined variations in occupational class inequalities in health within four employment sectors and the contribution of working conditions to these inequalities. Cross-sectional data from the Helsinki Health Study in 2000-2002 were used. Each year, employees of the City of Helsinki, aged 40-60 years, received a mailed questionnaire (n = 8,960, 80% women, overall response rate for 3 years 67%). The outcome was physical health functioning measured by the overall physical component summary of SF-36. The socioeconomic indicator was occupational social class. Employment sectors studied were health care, education, social welfare and administration (n = 6,557). Physical and mental workload, and job demands and job control were explanatory factors. Inequality indices from logistic regression analysis were calculated. Occupational class inequalities in physical health functioning were slightly larger in education (1.47) than in the other sectors (1.43-1.40). Physical workload explained 95% of inequalities in social welfare and 32-36% in the other sectors. Job control also partly explained health inequalities. However, adjusting for mental workload and job demands resulted in larger health inequalities. Inequalities in physical health functioning were found within each employment sector, with minor variation in their magnitude. Physical workload was the main explanation for these inequalities, but its contribution varied between the sectors. In contrast, considering psychosocial working conditions led to wider inequalities. Improving physical working conditions among the lower occupational classes would help reduce health inequalities within different employment sectors.

Expressed racial identity and hypertension in a telephone survey sample from Toronto and Vancouver, Canada: do socioeconomic status, perceived discrimination and psychosocial stress explain the relatively high risk of hypertension for Black Canadians?

PubMed

Veenstra, Gerry

2012-10-12

Canadian research on racial health inequalities that foregrounds socially constructed racial identities and social factors which can explain consequent racial health inequalities is rare. This paper adopts a social typology of salient racial identities in contemporary Canada, empirically documents consequent racial inequalities in hypertension in an original survey dataset from Toronto and Vancouver, Canada, and then attempts to explain the inequalities in hypertension with information on socioeconomic status, perceived experiences with institutionalized and interpersonal discrimination, and psychosocial stress. Telephone interviews were conducted in 2009 with 706 randomly selected adults living in the City of Toronto and 838 randomly selected adults living in the Vancouver Census Metropolitan Area. Bivariate analyses and logistic regression modeling were used to examine relationships between racial identity, hypertension, socio-demographic factors, socioeconomic status, perceived discrimination and psychosocial stress. The Black Canadians in the sample were the most likely to report major and routine discriminatory experiences and were the least educated and the poorest. Black respondents were significantly more likely than Asian, South Asian and White respondents to report hypertension controlling for age, immigrant status and city of residence. Of the explanatory factors examined in this study, only educational attainment explained some of the relative risk of hypertension for Black respondents. Most of the risk remained unexplained in the models. Consistent with previous Canadian research, socioeconomic status explained a small portion of the relatively high risk of hypertension documented for the Black respondents. Perceived experiences of discrimination both major and routine and self-reported psychosocial stress did not explain these racial inequalities in hypertension. Conducting subgroup analyses by gender, discerning between real and perceived experiences of discrimination and considering potentially moderating factors such as coping strategy and internalization of racial stereotypes are important issues to address in future Canadian racial inequalities research of this kind.

Rural Math Talent, Now and Then

ERIC Educational Resources Information Center

Howley, Craig B.; Showalter, Daniel; Klein, Robert; Sturgill, Derek J.; Smith, Michael A.

2013-01-01

This article interprets inequality evident at the intersection of three realms: (a) mathematical talent (as a cultural phenomenon); (b) rural place and rural life; and (c) future economic, political, and ecological developments. The discussion explains this outlook on inequality, contextualizes interest in rural mathematics education, presents the…

Regional Inequality in Literacy in India.

ERIC Educational Resources Information Center

Tilak, Jandhyala B. G.

1978-01-01

Although India's literacy rate has increased, the faster population growth has increased the nation's total illiteracy. The paper reviews differences in literacy rates among various regions and examines factors to explain this inequality, concluding that compulsory education for children is not enough and that adult literacy campaigns are vital.…

Are health inequalities rooted in the past? Income inequalities in metabolic syndrome decomposed by childhood conditions

PubMed Central

San Sebastian, Miguel; Ivarsson, Anneli; Weinehall, Lars; Gustafsson, Per E.

2017-01-01

Abstract Background: Early life is thought of as a foundation for health inequalities in adulthood. However, research directly examining the contribution of childhood circumstances to the integrated phenomenon of adult social inequalities in health is absent. The present study aimed to examine whether, and to what degree, social conditions during childhood explain income inequalities in metabolic syndrome in mid-adulthood. Methods: The sample (N = 12 481) comprised all 40- and 50-year-old participants in the Västerbotten Intervention Program in Northern Sweden 2008, 2009 and 2010. Measures from health examinations were used to operationalize metabolic syndrome, which was linked to register data including socioeconomic conditions at age 40–50 years, as well as childhood conditions at participant age 10–12 years. Income inequality in metabolic syndrome in middle age was estimated by the concentration index and decomposed by childhood and current socioeconomic conditions using decomposition analysis. Results: Childhood conditions jointed explained 7% (men) to 10% (women) of health inequalities in middle age. Adding mid-adulthood sociodemographic factors showed a dominant contribution of chiefly current income and educational level in both gender. In women, the addition of current factors slightly attenuated the contribution of childhood conditions, but with paternal income and education still contributing. In contrast, the corresponding addition in men removed all explanation attributable to childhood conditions. Conclusions: Despite that the influence of early life conditions to adult health inequalities was considerably smaller than that of concurrent conditions, the study suggests that early interventions against social inequalities potentially could reduce health inequalities in the adult population for decades to come. PMID:27744345

The social gradient in oral health: Is there a role for dental anxiety?

PubMed

Bernabé, Eduardo; Humphris, Gerry; Freeman, Ruth

2017-08-01

To evaluate the contribution of dental anxiety to social gradients in different oral health outcomes and whether social gradients in oral health persist once dental anxiety is removed from the population examined. Data from 9035 British adults were analysed. Participants' socioeconomic position (SEP) was measured through education and household income. Dental anxiety was measured with the Modified Dental Anxiety Scale. Poor subjective oral health, oral impacts on quality of life and edentulism among all adults and the number of teeth, the number of decayed, missing and filled surfaces (DMFS) and sextants with pocketing among dentate adults were the oral health outcomes. The contribution of dental anxiety to absolute and relative social inequalities in each oral health outcome (measured with the Slope and Relative Index of Inequality [SII and RII], respectively) was estimated from regression models without and with adjustment for dental anxiety and quantified with the percentage attenuation. Interactions between each SEP indicator and dental anxiety were used to test what would happen if dental anxiety were removed from the whole population. The largest contribution of dental anxiety to explaining oral health inequalities was found for education gradients in perceived outcomes (11%-13%), but dental anxiety explained <4% of social gradients in edentulism. Among dentate adults, dental anxiety accounted for <5% and <7% of education and income gradients, respectively. Only four of the 24 interactions tested were statistically significant. Hence, the education- and income-based SII and RII for oral impacts were nonsignificant among anxiety-free adults but were significant at higher levels of dental anxiety. Little support was found for the role of dental anxiety in explaining social inequalities in various perceived and clinical oral health measures. Oral health inequalities were found among both nondentally anxious and anxious participants. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The impact of increasing income inequalities on educational inequalities in mortality - An analysis of six European countries.

PubMed

Hoffmann, Rasmus; Hu, Yannan; de Gelder, Rianne; Menvielle, Gwenn; Bopp, Matthias; Mackenbach, Johan P

2016-07-08

Over the past decades, both health inequalities and income inequalities have been increasing in many European countries, but it is unknown whether and how these trends are related. We test the hypothesis that trends in health inequalities and trends in income inequalities are related, i.e. that countries with a stronger increase in income inequalities have also experienced a stronger increase in health inequalities. We collected trend data on all-cause and cause-specific mortality, as well as on the household income of people aged 35-79, for Belgium, Denmark, England & Wales, France, Slovenia, and Switzerland. We calculated absolute and relative differences in mortality and income between low- and high-educated people for several time points in the 1990s and 2000s. We used fixed-effects panel regression models to see if changes in income inequality predicted changes in mortality inequality. The general trend in income inequality between high- and low-educated people in the six countries is increasing, while the mortality differences between educational groups show diverse trends, with absolute differences mostly decreasing and relative differences increasing in some countries but not in others. We found no association between trends in income inequalities and trends in inequalities in all-cause mortality, and trends in mortality inequalities did not improve when adjusted for rising income inequalities. This result held for absolute as well as for relative inequalities. A cause-specific analysis revealed some association between income inequality and mortality inequality for deaths from external causes, and to some extent also from cardiovascular diseases, but without statistical significance. We find no support for the hypothesis that increasing income inequality explains increasing health inequalities. Possible explanations are that other factors are more important mediators of the effect of education on health, or more simply that income is not an important determinant of mortality in this European context of high-income countries. This study contributes to the discussion on income inequality as entry point to tackle health inequalities. More research is needed to test the common and plausible assumption that increasing income inequality leads to more health inequality, and that one needs to act against the former to avoid the latter.

Inequalities in School Leavers' Labour Market Outcomes: Do School Subject Choices Matter?

ERIC Educational Resources Information Center

Iannelli, Cristina; Duta, Adriana

2018-01-01

Despite a wide international literature on the effect of vocational and general education on school-to-work transition, relatively little is known about the role of having studied specific subjects in explaining inequalities in young people's labour market outcomes. This paper aims to fill this gap by examining differences in employment chances of…

Socio-economic inequalities in malnutrition among children and adolescents in Colombia: the role of individual-, household- and community-level characteristics.

PubMed

Garcia, Sandra; Sarmiento, Olga L; Forde, Ian; Velasco, Tatiana

2013-09-01

To examine socio-economic inequalities in malnutrition among Colombian children and adolescents, and to assess the contribution of individual-, household- and community-level factors to those inequalities. Cross-sectional data were used from two sources: 2005 Colombian Demographic and Health Survey and 2005 Colombian census. Malnutrition outcomes included stunting and overweight. Multilevel Poisson models were used to estimate the association between individual, household and contextual characteristics and malnutrition. Changes in prevalence ratios of the poorest quintile (v. richest) were compared to assess the contribution of different characteristics to inequalities in malnutrition. Population-based, representative of Colombia. Children and adolescents <18 years of age (n 30 779) from the Colombian Demographic and Health Survey. Children and adolescents living in the poorest households were close to five times more likely to be stunted, while those from the richest households were 1.3–2.8 times more likely than their poorest counterparts to be overweight. Care practices and household characteristics, particularly mother’s education, explained over one-third of socio-economic inequalities in stunting. The proportion explained by access to services was not negligible (between 6% and 14 %). Access to sanitation was significantly associated with a lower prevalence of stunting for all age groups. Between 14% and 32% of socio-economic disparities in overweight were explained by maternal and household characteristics. Mother’s overweight was positively associated with overweight of the child. Socio-economic inequalities in stunting and overweight coexist among children and adolescents in Colombia. Malnutrition inequalities are largely explained by household characteristics, suggesting the need for targeted interventions.

Social inequalities in health: measuring the contribution of housing deprivation and social interactions for Spain

PubMed Central

2012-01-01

Introduction Social factors have been proved to be main determinants of individuals’ health. Recent studies have also analyzed the contribution of some of those factors, such as education and job status, to socioeconomic inequalities in health. The aim of this paper is to provide new evidence about the factors driving socioeconomic inequalities in health for the Spanish population by including housing deprivation and social interactions as health determinants. Methods Cross-sectional study based on the Spanish sample of European Statistics on Income and Living Conditions (EU-SILC) for 2006. The concentration index measuring income-related inequality in health is decomposed into the contribution of each determinant. Several models are estimated to test the influence of different regressors for three proxies of ill-health. Results Health inequality favouring the better-off is observed in the distribution of self-assessed health, presence of chronic diseases and presence of limiting conditions. Inequality is mainly explained, besides age, by social factors such as labour status and financial deprivation. Housing deprivation contributes to pro-rich inequality in a percentage ranging from 7.17% to 13.85%, and social interactions from 6.16% to 10.19%. The contribution of some groups of determinants significantly differs depending on the ill-health variable used. Conclusions Health inequalities can be mostly reduced or shaped by policy, as they are mainly explained by social determinants such as labour status, education and other socioeconomic conditions. The major role played on health inequality by variables taking part in social exclusion points to the need to focus on the most vulnerable groups. JEL Codes H51, I14, I18 PMID:23241384

Decomposing Kenyan socio-economic inequalities in skilled birth attendance and measles immunization

PubMed Central

2013-01-01

Introduction Skilled birth attendance (SBA) and measles immunization reflect two aspects of a health system. In Kenya, their national coverage gaps are substantial but could be largely improved if the total population had the same coverage as the wealthiest quintile. A decomposition analysis allows identifying the factors that influence these wealth-related inequalities in order to develop appropriate policy responses. The main objective of the study was to decompose wealth-related inequalities in SBA and measles immunization into their contributing factors. Methods Data from the Kenyan Demographic and Health Survey 2008/09 were used. The study investigated the effects of socio-economic determinants on [1] coverage and [2] wealth-related inequalities of SBA utilization and measles immunization. Techniques used were multivariate logistic regression and decomposition of the concentration index (C). Results SBA utilization and measles immunization coverage differed according to household wealth, parent’s education, skilled antenatal care visits, birth order and father’s occupation. SBA utilization further differed across provinces and ethnic groups. The overall C for SBA was 0.14 and was mostly explained by wealth (40%), parent’s education (28%), antenatal care (9%), and province (6%). The overall C for measles immunization was 0.08 and was mostly explained by wealth (60%), birth order (33%), and parent’s education (28%). Rural residence (−19%) reduced this inequality. Conclusion Both health care indicators require a broad strengthening of health systems with a special focus on disadvantaged sub-groups. PMID:23294938

Welfare states, the Great Recession and health: Trends in educational inequalities in self-reported health in 26 European countries.

PubMed

Leão, Teresa; Campos-Matos, Inês; Bambra, Clare; Russo, Giuliano; Perelman, Julian

2018-01-01

Although socioeconomic inequalities in health have long been observed in Europe, few studies have analysed their recent patterning. In this paper, we examined how educational inequalities in self-reported health have evolved in different European countries and welfare state regimes over the last decade, which was troubled by the Great Recession. We used cross-sectional data from the EU-SILC survey for adults from 26 European countries, from 2005 to 2014 (n = 3,030,595). We first calculated education-related absolute (SII) and relative (RII) inequalities in poor self-reported health by country-year, adjusting for age, sex, and EU-SILC survey weights. We then regressed the year- and country-specific RII and SII on a yearly time trend, globally and by welfare regime, adjusting for country fixed effects. We further adjusted the analysis for the economic cycle using GDP growth, unemployment, and income inequality. Overall, absolute inequalities persisted and relative inequalities slightly widened (betaRII = 0.0313, p<0.05). There were substantial differences by welfare regime: Anglo-Saxon countries experienced the largest increase in absolute inequalities (betaSII = 0.0032, p<0.05), followed by Bismarkian countries (betaSII = 0.0024, p<0.001), while they reduced in Post-Communist countries (betaSII = -0.0022, p<0.001). Post-Communist countries also experienced a widening in relative inequalities (betaRII = 0.1112, p<0.001), which were found to be stable elsewhere. Adjustment for income inequality only explained such trend in Anglo-Saxon countries. Educational inequalities in health have overall persisted across European countries over the last decade. However, there is considerable variation across welfare regimes, possibly related to underpinning social safety nets and to austerity measures implemented during this 10-year period.

Welfare states, the Great Recession and health: Trends in educational inequalities in self-reported health in 26 European countries

PubMed Central

Campos-Matos, Inês; Bambra, Clare; Russo, Giuliano

2018-01-01

Background Although socioeconomic inequalities in health have long been observed in Europe, few studies have analysed their recent patterning. In this paper, we examined how educational inequalities in self-reported health have evolved in different European countries and welfare state regimes over the last decade, which was troubled by the Great Recession. Methods We used cross-sectional data from the EU-SILC survey for adults from 26 European countries, from 2005 to 2014 (n = 3,030,595). We first calculated education-related absolute (SII) and relative (RII) inequalities in poor self-reported health by country-year, adjusting for age, sex, and EU-SILC survey weights. We then regressed the year- and country-specific RII and SII on a yearly time trend, globally and by welfare regime, adjusting for country fixed effects. We further adjusted the analysis for the economic cycle using GDP growth, unemployment, and income inequality. Results Overall, absolute inequalities persisted and relative inequalities slightly widened (betaRII = 0.0313, p<0.05). There were substantial differences by welfare regime: Anglo-Saxon countries experienced the largest increase in absolute inequalities (betaSII = 0.0032, p<0.05), followed by Bismarkian countries (betaSII = 0.0024, p<0.001), while they reduced in Post-Communist countries (betaSII = -0.0022, p<0.001). Post-Communist countries also experienced a widening in relative inequalities (betaRII = 0.1112, p<0.001), which were found to be stable elsewhere. Adjustment for income inequality only explained such trend in Anglo-Saxon countries. Conclusions Educational inequalities in health have overall persisted across European countries over the last decade. However, there is considerable variation across welfare regimes, possibly related to underpinning social safety nets and to austerity measures implemented during this 10-year period. PMID:29474377

Educational inequalities in smoking: the role of initiation versus quitting.

PubMed

Maralani, Vida

2013-05-01

The existing literature on educational inequalities in adult smoking has focused extensively on differences in current smoking and quitting, rather than on differences in never smoking regularly (initiation) by education in the adult population. Knowing the relative contribution of initiation versus quitting is critical for understanding the mechanisms that produce educational gradients in smoking because initiation and quitting occur at different points in the life course. Using data from 31 waves of the U.S. National Health Interview Survey (N = 587,174), the analyses show the relative likelihood of being a never versus former smoker by education, sex, and age from 1966 to 2010 and for birth cohorts from 1920 to 1979. The analyses also describe differences in the cumulative probability of quitting over the life course, and the role of initiation versus quitting in producing educational gaps in smoking. The results show that educational gaps in never smoking explain the bulk of the educational inequality in adult smoking. Differences in former smoking play a small and decreasing role in producing these gaps. This is true across the life course, whether measured at age 25 or age 50, and for both men and women. While the prevalence and age patterns of former smoking by education converge across birth cohorts, differences in never smoking by education increase dramatically. At the population level, educational gaps in adult smoking are produced by the combination of inequalities in initiation and quitting, with differences in initiation playing a larger role in producing the observed gaps. The portion of the gap explained by differences in quitting is itself a function of educational differences in initiation. Thus, educational gradients in adult smoking are tethered to experiences in adolescence. These findings have important implications for both understanding and addressing disparities in this important health behavior. Copyright © 2013 Elsevier Ltd. All rights reserved.

Measuring the global information society - explaining digital inequality by economic level and education standard

NASA Astrophysics Data System (ADS)

Ünver, H.

2017-02-01

A main focus of this research paper is to investigate on the explanation of the ‘digital inequality’ or ‘digital divide’ by economic level and education standard of about 150 countries worldwide. Inequality regarding GDP per capita, literacy and the so-called UN Education Index seem to be important factors affecting ICT usage, in particular Internet penetration, mobile phone usage and also mobile Internet services. Empirical methods and (multivariate) regression analysis with linear and non-linear functions are useful methods to measure some crucial factors of a country or culture towards becoming information and knowledge based society. Overall, the study concludes that the convergence regarding ICT usage proceeds worldwide faster than the convergence in terms of economic wealth and education in general. The results based on a large data analysis show that the digital divide is declining over more than a decade between 2000 and 2013, since more people worldwide use mobile phones and the Internet. But a high digital inequality explained to a significant extent by the functional relation between technology penetration rates, education level and average income still exists. Furthermore it supports the actions of countries at UN/G20/OECD level for providing ICT access to all people for a more balanced world in context of sustainable development by postulating that policymakers need to promote comprehensive education worldwide by means of using ICT.

Changing educational inequalities in sporting inactivity among adults in Germany: a trend study from 2003 to 2012.

PubMed

Hoebel, Jens; Finger, Jonas D; Kuntz, Benjamin; Kroll, Lars E; Manz, Kristin; Lange, Cornelia; Lampert, Thomas

2017-06-06

Social inequalities in health can be explained in part by the social patterning of leisure-time physical activity, such as non-participation in sports. This study is the first to explore whether absolute and relative educational inequalities in sporting inactivity among adults have changed in Germany since the early 2000s. Data from four cross-sectional national health surveys conducted in 2003 (n = 6890), 2009 (n = 16,418), 2010 (n = 17,145) and 2012 (n = 13,744) were analysed. The study population was aged 25-69 years in each survey. Sporting inactivity was defined as no sports participation during the preceding 3 months. The regression-based Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were calculated to estimate the extent of absolute and relative educational inequalities in sporting inactivity, respectively. Sporting inactivity was consistently more prevalent in less-educated groups. The overall prevalence of sporting inactivity declined significantly over time. However, the decline was observed only in the high and medium education groups, while no change was observed in the low education group. Both absolute and relative educational inequalities in sporting inactivity were found to have widened significantly between 2003 (SII = 0.30, 95% CI = 0.25-0.35; RII = 2.08, 95% CI = 1.83-2.38) and 2012 (SII = 0.41, 95% CI = 0.37-0.45; RII = 3.44, 95% CI = 3.03-3.91). Interaction analysis showed that these increases in inequalities were larger in the younger population under the age of 50 than among the elderly. The findings suggest that the gap in sports participation between adults with high and low educational attainment has widened in both absolute and relative terms because of an increase in sports participation among the better educated. Health-enhancing physical activity interventions specifically targeted to less-educated younger adults are needed to prevent future increases in social inequalities in health.

Determinants of immunization inequality among urban poor children: evidence from Nairobi's informal settlements.

PubMed

Egondi, Thaddaeus; Oyolola, Maharouf; Mutua, Martin Kavao; Elung'ata, Patricia

2015-02-27

Despite the relentless efforts to reduce infant and child mortality with the introduction of the National Expanded Programmes on Immunization (EPI) in 1974, major disparities still exist in immunizations coverage across different population sub-groups. In Kenya, for instance, while the proportion of fully immunized children increased from 57% in 2003 to 77% in 2008-9 at national level and 73% in Nairobi, only 58% of children living in informal settlement areas are fully immunized. The study aims to determine the degree and determinants of immunization inequality among the urban poor of Nairobi. We used data from the Nairobi Cross-Sectional Slum Survey of 2012 and the health outcome was full immunization status among children aged 12-23 months. The wealth index was used as a measure of social economic position for inequality analysis. The potential determinants considered included sex of the child and mother's education, their occupation, age at birth of the child, and marital status. The concentration index (CI) was used to quantify the degree of inequality and decomposition approach to assess determinants of inequality in immunization. The CI for not fully immunized was -0.08 indicating that immunization inequality is mainly concentrated among children from poor families. Decomposition of the results suggests that 78% of this inequality is largely explained by the mother's level of education. There exists immunization inequality among urban poor children in Nairobi and efforts to reduce this inequality should aim at targeting mothers with low level of education during immunization campaigns.

Explaining Parents' School Involvement: The Role of Ethnicity and Gender in the Netherlands

ERIC Educational Resources Information Center

Fleischmann, Fenella; de Haas, Annabel

2016-01-01

Ethnic minority parents are often less involved with their children's schooling, and this may hamper their children's academic success, thus contributing to ethnic educational inequality. The authors aim to explain differences in parental involvement, using nationally representative survey data from the Netherlands of parents of primary…

Explaining levels of within-group wage inequality in U.S. labor markets.

PubMed

McCall, L

2000-11-01

Most research on earnings inequality has focused on the growing gap between workers of different races and at different education, age, and income levels, but a large portion of the increasing inequality has actually occurred within these groups. This article focuses on the extent and sources of "within-group" wage inequality in more than 500 labor markets in the United States in 1990. In addition to documenting that within-group wage inequality across regions varies more widely today than over the past several decades, the analysis reveals that two frequently cited explanations of rising wage inequality over time have little impact on within-group wage inequality when measured at the local labor market level: (1) industrial shifts and (2) increased technology and trade. By contrast, flexible and insecure employment conditions (e.g., unemployment, contingent work, and immigration) are associated strongly with high local levels of within-group wage inequality, especially among women.

The Artifacts of Educational Reform: Explaining the Unexpected.

ERIC Educational Resources Information Center

Ascher, Gordon

The inequality of opportunity that sometimes results from educational reform may not be an artifact or an aberration but may be the intended result of most programs. Although the ostensible goal of most educational reform is equal opportunity, very few programs achieve this goal. It is possible that the real goal of educational reform is continued…

Religiosity, the Headscarf, and Education in Turkey: An Analysis of 1988 Data and Current Implications

ERIC Educational Resources Information Center

Rankin, Bruce H.; Aytac, Isik A.

2008-01-01

Previous research highlights the continuing relevance of family culture in explaining educational inequalities in Turkey, especially patriarchal beliefs and practices that discourage investment in the education of girls. We extend that research by introducing two much-debated, but empirically untested, aspects of family culture--parental…

Social Education Politics in a Europe of Inequalities

ERIC Educational Resources Information Center

Cortés, Javier Bascuñan

2013-01-01

The aim of this research is to analyse some indicators which allow us to understand the current state of social education politics in Europe, with special reference to Spain. Some European and Spanish social and educational policies which try to confront the challenges of the current financial crisis are also explained. Some deficiencies, failures…

Association between unemployment, income, education level, population size and air pollution in Czech cities: evidence for environmental inequality? A pilot national scale analysis.

PubMed

Branis, Martin; Linhartova, Martina

2012-09-01

We analyzed differentials in exposure to SO(2), PM(10) and NO(2) among Czech urban populations categorized according to education level, unemployment rate, population size and average annual salary. Altogether 39 cities were included in the analysis. The principal component analysis revealed two factors explaining 72.8% of the data variability. The first factor explaining 44.7% of the data variability included SO(2), PM(10), low education level and high unemployment, documenting that inhabitants with unfavorable socioeconomic status mainly reside in smaller cities with higher concentration levels of combustion-related air pollutants. The second factor explaining 28.1% of the data variability included NO(2), high salary, high education level and large population, suggesting that large cities with residents with higher socioeconomic status are exposed to higher levels of traffic-related air pollution. We conclude that, after more than a decade of free-market economy, the Czech Republic, a former Soviet satellite with a centrally planned economy, displays signs of a certain kind of environmental inequality, since environmental hazards are unevenly distributed among the Czech urban populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

Decomposition of Economic Inequality in Needle and Syringe Programs Utilization to its Determinants among Men Who Inject Drugs in Tehran using Blinder-Oaxaca Decomposition Method.

PubMed

Noroozi, Mehdi; Rahimi, Ebrahim; Ghisvand, Hessam; Qorbani, Mostafa; Sharifi, Hamid; Noroozi, Alireza; Farhoudian, Ali; Marshall, Brandon D L; Jorjoran Shoshtari, Zahra; Karimi, Salah Eddin; Rezaei, Omid; Armoon, Bahram

2018-06-07

According to latest available data there are more of 300,000 people injects drug users (PWID) in Iran. In this study, we used a Blinder-Oaxaca (BO) decomposition to explore the relative contributions of inequality in utilization of NSPs and to decompose it to its determinants in Teheran. We used data from a cross-sectional survey using snowball sampling to recruit 500 PWID from June to July 2016 in Tehran. Participants were reported injecting drug use in the past month, were able to speak and comprehend Farsi enough to respond to survey questions, and were able to provide informed consent to complete the interview. We used a BO method to decompose the role of economic inequality on utilization of needle and syringe programs. A total 520 of clients participated in the study of which data was fully complete for 500. The selected predictor variables (age, education level, marital status, homelessness, HIV risk perception, and HIV knowledge) together explain 54% (8.5% out of 16%) of total inequality in utilization of needle and syringe programs and the remaining 46% constitute the unexplained residual. HIV risk perception status contributed about 38% (3.3% out of 8.5%) to the total health inequality, followed by HIV knowledge (26%) and education level were contributed 20% each, respectively. The results showed that contribution of economic inequalities in utilization of NSPs was primarily explained by the differential effects of HIV risk perception and HIV knowledge among PWID. Reducing HIV risk perception and increasing HIV knowledge might be essential to efforts to eliminate inequalities in access to NSPs among PWID.

Educational Inequalities in Post-Hip Fracture Mortality: A NOREPOS Study.

PubMed

Omsland, Tone K; Eisman, John A; Naess, Øyvind; Center, Jacqueline R; Gjesdal, Clara G; Tell, Grethe S; Emaus, Nina; Meyer, Haakon E; Søgaard, Anne Johanne; Holvik, Kristin; Schei, Berit; Forsmo, Siri; Magnus, Jeanette H

2015-12-01

Hip fractures are associated with high excess mortality. Education is an important determinant of health, but little is known about educational inequalities in post-hip fracture mortality. Our objective was to investigate educational inequalities in post-hip fracture mortality and to examine whether comorbidity or family composition could explain any association. We conducted a register-based population study of Norwegians aged 50 years and older from 2002 to 2010. We measured total mortality according to educational attainment in 56,269 hip fracture patients (NORHip) and in the general Norwegian population. Both absolute and relative educational inequalities in mortality in people with and without hip fracture were compared. There was an educational gradient in post-hip fracture mortality in both sexes. Compared with those with primary education only, the age-adjusted relative risk (RR) of mortality in hip fracture patients with tertiary education was 0.82 (95% confidence interval [CI] 0.77-0.87) in men and 0.79 (95% CI 0.75-0.84) in women. Additional adjustments for Charlson comorbidity index, marital status, and number of children did not materially change the estimates. Regardless of educational attainment, the 1-year age-adjusted mortality was three- to fivefold higher in hip fracture patients compared with peers in the general population without fracture. The absolute differences in 1-year mortality according to educational attainment were considerably larger in hip fracture patients than in the population without hip fracture. Absolute educational inequalities in mortality were higher after hip fracture compared with the general population without hip fracture and were not mediated by comorbidity or family composition. Investigation of other possible mediating factors might help to identify new targets for interventions, based on lower educational attainment, to reduce post-hip fracture mortality. © 2015 American Society for Bone and Mineral Research.

Correlates of socio-economic inequalities in women's television viewing: a study of intrapersonal, social and environmental mediators.

PubMed

Teychenne, Megan; Ball, Kylie; Salmon, Jo

2012-01-20

Socio-economically disadvantaged women are at a greater risk of spending excess time engaged in television viewing, a behavior linked to several adverse health outcomes. However, the factors which explain socio-economic differences in television viewing are unknown. This study aimed to investigate the contribution of intrapersonal, social and environmental factors to mediating socio-economic (educational) inequalities in women's television viewing. Cross-sectional data were provided by 1,554 women (aged 18-65) who participated in the 'Socio-economic Status and Activity in Women study' of 2004. Based on an ecological framework, women self-reported their socio-economic position (highest education level), television viewing, as well as a number of potential intrapersonal (enjoyment of television viewing, preference for leisure-time sedentary behavior, depression, stress, weight status), social (social participation, interpersonal trust, social cohesion, social support for physical activity from friends and from family) and physical activity environmental factors (safety, aesthetics, distance to places of interest, and distance to physical activity facilities). Multiple mediating analyses showed that two intrapersonal factors (enjoyment of television viewing and weight status) and two social factors (social cohesion and social support from friends for physical activity) partly explained the educational inequalities in women's television viewing. No physical activity environmental factors mediated educational variations in television viewing. Acknowledging the cross-sectional nature of this study, these findings suggest that health promotion interventions aimed at reducing educational inequalities in television viewing should focus on intrapersonal and social strategies, particularly providing enjoyable alternatives to television viewing, weight-loss/management information, increasing social cohesion in the neighborhood and promoting friend support for activity.

Towards a New Theory of Gender Inequities in Labour Market Outcomes of Education.

ERIC Educational Resources Information Center

Quinlan, Liz

Attempts to explain sex-related wage differentials generally rely on the human capital and segmentation labor market theories. The human capital theory explains individuals' position in the labor market primarily in terms of factors determining their productivity, whereas segmentation theory focuses on differences among jobs as determinants of the…

Ahead of the Pack? Explaining the Unequal Distribution of Scholarships in Germany

ERIC Educational Resources Information Center

Haas, Christina; Van De Werfhorst, Herman

2017-01-01

This article investigates to what extent scholarships are unequally distributed among students in Germany and how these inequalities can be explained. Following sociological theory, the article argues that elites seek qualitative ways of distinguishing themselves in a mass higher education system. Using student surveys, we demonstrate that class…

Education Finance Reform, Education Spending, and Student Performance: Evidence from Maryland's Bridge to Excellence in Public Schools Act

ERIC Educational Resources Information Center

Chung, Il Hwan

2015-01-01

The disparities in achievement among income and racial-ethnic groups of students have long been a major concern of educational policies. Among several identified factors that help explain the student performance gap, this paper focuses on inequity in funding for education among school districts, which resulted from heavy reliance of school…

What's a Nice Test Like You Doing in a Place Like This? The edTPA and Corporate Education "Reform"

ERIC Educational Resources Information Center

Au, Wayne

2013-01-01

This author explains why he believes that teacher education is under attack. The same forces that are seeking to dismantle teachers' unions and de-professionalize teaching have their sights set on university-based teacher education programs. After all, logic decrees that if teachers are to blame for educational inequality--as corporate education…

Elder abuse and socioeconomic inequalities: a multilevel study in 7 European countries.

PubMed

Fraga, Sílvia; Lindert, Jutta; Barros, Henrique; Torres-González, Francisco; Ioannidi-Kapolou, Elisabeth; Melchiorre, Maria Gabriella; Stankunas, Mindaugas; Soares, Joaquim F

2014-04-01

To compare the prevalence of elder abuse using a multilevel approach that takes into account the characteristics of participants as well as socioeconomic indicators at city and country level. In 2009, the project on abuse of elderly in Europe (ABUEL) was conducted in seven cities (Stuttgart, Germany; Ancona, Italy; Kaunas, Lithuania, Stockholm, Sweden; Porto, Portugal; Granada, Spain; Athens, Greece) comprising 4467 individuals aged 60-84 years. We used a 3-level hierarchical structure of data: 1) characteristics of participants; 2) mean of tertiary education of each city; and 3) country inequality indicator (Gini coefficient). Multilevel logistic regression was used and proportional changes in Intraclass Correlation Coefficient (ICC) were inspected to assert explained variance between models. The prevalence of elder abuse showed large variations across sites. Adding tertiary education to the regression model reduced the country level variance for psychological abuse (ICC=3.4%), with no significant decrease in the explained variance for the other types of abuse. When the Gini coefficient was considered, the highest drop in ICC was observed for financial abuse (from 9.5% to 4.3%). There is a societal and community level dimension that adds information to individual variability in explaining country differences in elder abuse, highlighting underlying socioeconomic inequalities leading to such behavior. Copyright © 2014 Elsevier Inc. All rights reserved.

Ethnic Gaps in Educational Attainment and Labor-Market Outcomes: Evidence from France

ERIC Educational Resources Information Center

Langevin, Gabin; Masclet, David; Moizeau, Fabien; Peterle, Emmanuel

2017-01-01

We use data from the "Trajectoires et Origines" survey to analyze ethnic gaps in education and labor-market outcomes between second-generation immigrants and their French-native counterparts. Our three main findings underscore the importance of family background in explaining lifelong ethnic inequalities. First, second-generation…

Decomposing socioeconomic inequality in infant mortality in Iran.

PubMed

Hosseinpoor, Ahmad Reza; Van Doorslaer, Eddy; Speybroeck, Niko; Naghavi, Mohsen; Mohammad, Kazem; Majdzadeh, Reza; Delavar, Bahram; Jamshidi, Hamidreza; Vega, Jeanette

2006-10-01

Although measuring socioeconomic inequality in population health indicators like infant mortality is important, more interesting for policy purposes is to try to explain infant mortality inequality. The objective of this paper is to quantify for the first time the determinants' contributions of socioeconomic inequality in infant mortality in Iran. A nationally representative sample of 108 875 live births from October 1990 to September 1999 was selected. The data were taken from the Iranian Demographic and Health Survey (DHS) conducted in 2000. Households' socioeconomic status was measured using principal component analysis. The concentration index of infant mortality was used as our measure of socioeconomic inequality and decomposed into its determining factors. The largest contributions to inequality in infant mortality were owing to household economic status (36.2%) and mother's education (20.9%). Residency in rural/urban areas (13.9%), birth interval (13.0%), and hygienic status of toilet (11.9%) also proved important contributors to the measured inequality. The findings indicate that socioeconomic inequality in infant mortality in Iran is determined not only by health system functions but also by factors beyond the scope of health authorities and care delivery system. This implies that in addition to reducing inequalities in wealth and education, investments in water and sanitation infrastructure and programmes (especially in rural areas) are necessary to realize improvements of inequality in infant mortality across society. These findings can be instrumental for the recent 5 year Economic, Social and Cultural Development Plan of Iran, which identified the reduction of inequalities in social determinants of health.

Decomposing socio-economic inequalities in leisure-time physical inactivity: the case of Spanish children.

PubMed

Gonzalo-Almorox, Eduardo; Urbanos-Garrido, Rosa M

2016-07-12

Physical inactivity is associated with an increased risk of all-cause mortality and entails a substantial economic burden for health systems. Also, the analysis of inequality in lifestyles for young populations may contribute to reduce health inequalities during adulthood. This paper examines the income-related inequality regarding leisure-time physical inactivity in Spanish children. In this cross-sectional study based on the Spanish National Health Survey for 2011-12, concentration indices are estimated to measure socioeconomic inequalities in leisure-time physical inactivity. A decomposition analysis is performed to determine the factors that explain income-related inequalities. There is a significant socioeconomic gradient favouring the better-off associated with leisure-time physical inactivity amongst Spanish children, which is more pronounced in the case of girls. Income shows the highest contribution to total inequality, followed by education of the head of the household. The contribution of several factors (education, place of residence, age) significantly differs by gender. There is an important inequity in the distribution of leisure-time physical inactivity. Public policies aimed at promoting physical activity for children should prioritize the action into the most disadvantaged subgroups of the population. As the influence of determinants of health styles significantly differ by gender, this study points out the need of addressing the research on income-related inequalities in health habits from a gender perspective.

The role of the built environment in explaining educational inequalities in walking and cycling among adults in the Netherlands.

PubMed

van Wijk, Daniël C; Groeniger, Joost Oude; van Lenthe, Frank J; Kamphuis, Carlijn B M

2017-03-31

This study examined whether characteristics of the residential built environment (i.e. population density, level of mixed land use, connectivity, accessibility of facilities, accessibility of green) contributed to educational inequalities in walking and cycling among adults. Data from participants (32-82 years) of the 2011 survey of the Dutch population-based GLOBE study were used (N = 2375). Highest attained educational level (independent variable) and walking for transport, cycling for transport, walking in leisure time and cycling in leisure time (dependent variables) were self-reported in the survey. GIS-systems were used to obtain spatial data on residential built environment characteristics. A four-step mediation-based analysis with log-linear regression models was used to examine to contribution of the residential built environment to educational inequalities in walking and cycling. As compared to the lowest educational group, the highest educational group was more likely to cycle for transport (RR 1.13, 95% CI 1.04-1.23), walk in leisure time (RR 1.12, 95% CI 1.04-1.21), and cycle in leisure time (RR 1.12, 95% CI 1.03-1.22). Objective built environment characteristics were related to these outcomes, but contributed minimally to educational inequalities in walking and cycling. On the other hand, compared to the lowest educational group, the highest educational group was less likely to walk for transport (RR 0.91, 95% CI 0.82-1.01), which could partly be attributed to differences in the built environment. This study found that objective built environment characteristics contributed minimally to educational inequalities in walking and cycling in the Netherlands.

Educational inequality in cardiovascular diseases: a sibling approach.

PubMed

Søndergaard, Grethe; Dalton, Susanne Oksbjerg; Mortensen, Laust Hvas; Osler, Merete

2018-02-01

Educational inequality in diseases in the circulatory system (here termed cardiovascular disease) is well documented but may be confounded by early life factors. The aim of this observational study was to examine whether the associations between education and all cardiovascular diseases, ischaemic heart disease and stroke, respectively, were explained by family factors shared by siblings. The study population included all individuals born in Denmark between 1950 and 1979 who had at least one full sibling born in the same period. Using Cox regression, data were analysed in conventional cohort and within-sibship analyses in which the association was examined within siblings discordant on education. Assuming that attenuation of associations in the within-sibship as compared with the cohort analyses would indicate confounding from factors shared within families. A lower educational status was associated with a higher risk of cardiovascular disease, ischaemic heart disease and stroke. All associations attenuated in the within-sibship analyses, in particular in the analyses on ischaemic heart disease before age 45 years. For instance, in the cohort analyses, the hazard rate of ischaemic heart disease among women less than 45 years who had a primary school education was 94% (hazard ratio 1.94 (1.78-2.12) higher than among those with a vocational education, while it attenuated to 51% (hazard ratio 1.51 (1.34-1.71)) in the within-sibship analysis. Confounding from factors shared by siblings explained the associations between education and the cardiovascular disease outcomes but to varying degrees. This should be taken into account when planning interventions aimed at reducing educational inequalities in the development of cardiovascular disease, ischaemic heart disease and stroke.

Pathways of equality through education: impact of gender (in)equality and maternal education on exclusive breastfeeding among natives and migrants in Belgium.

PubMed

Vanderlinden, Karen; Van de Putte, Bart

2017-04-01

Even though breastfeeding is typically considered the preferred feeding method for infants worldwide, in Belgium, breastfeeding rates remain low across native and migrant groups while the underlying determinants are unclear. Furthermore, research examining contextual effects, especially regarding gender (in)equality and ideology, has not been conducted. We hypothesized that greater gender equality scores in the country of origin will result in higher breastfeeding chances. Because gender equality does not operate only at the contextual level but can be mediated through individual level resources, we hypothesized the following for maternal education: higher maternal education will be an important positive predictor for exclusive breastfeeding chances in Belgium, but its effects will differ over subsequent origin countries. Based on IKAROS data (GeÏntegreerd Kind Activiteiten en Regio Ondersteunings Systeem), we perform multilevel analyses on 27 936 newborns. Feeding method is indicated by exclusive breastfeeding 3 months after childbirth. We measure gender (in)equality using Global Gender Gap scores from the mother's origin country. Maternal education is a metric variable based on International Standard Classification of Education indicators. Results show that 3.6% of the variation in breastfeeding can be explained by differences between the migrant mother's country of origin. However, the effect of gender (in)equality appears to be non-significant. After adding maternal education, the effect for origin countries scoring low on gender equality turns significant. Maternal education on its own shows strong positive association with exclusive breastfeeding and, furthermore, has different effects for different origin countries. Possible explanations are discussed in-depth setting direction for further research regarding the different pathways gender (in)equality and maternal education affect breastfeeding. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

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.

Teacher/Student Classroom Interaction in Vocational Education. A Sex Bias/Sex Stereotyping Project.

ERIC Educational Resources Information Center

Omvig, Clayton P.

A study examined teacher-student interaction in Kentucky's secondary and postsecondary vocational education classrooms. It investigated whether sex bias or inequities were present and what might explain such differences. A literature review focused on studies conducted at different grade levels with relation to sex bias and classroom interactions.…

Systemic Obstacles to Lifelong Learning: The Influence of the Educational System Design on Learning Attitudes

ERIC Educational Resources Information Center

Lavrijsen, Jeroen; Nicaise, Ides

2017-01-01

Comparative research has often emphasized the importance of external barriers (e.g. enrolment costs) to explain inequalities in lifelong learning participation. However, individuals, in particular the low educated, are often not only prevented from participation by external barriers, but also by negative psychological dispositions about learning.…

Ethnicity, Disadvantage and Other Variables in the Analysis of Birmingham Longitudinal School Attainment Datasets

ERIC Educational Resources Information Center

Parsons, Carl; Thompson, Trevor

2017-01-01

Explaining and responding to inequalities in attainment are significant educational policy challenges in England as elsewhere. Data on four cohorts of Birmingham Local Education Authority (LEA) pupils, each approximately 13,000, were analysed by ethnicity, deprivation, gender and other relevant individual pupil variables. For the four successive…

Determinants of inequality in the up-to-date fully immunization coverage among children aged 24-35 months: Evidence from Zhejiang province, East China.

PubMed

Hu, Yu; Wang, Ying; Chen, Yaping; Li, Qian

2017-08-03

This study aimed to determine the degree and determinants of inequality in up-to-date fully immunization (UTDFI) coverage among children of Zhejiang province, east China. We used data from the Zhejiang provincial vaccination coverage survey of 2014 and the health outcome was the UTDFI status among children aged 24-35 months. The household income per month was used as an index of socio-economic status for the inequality analysis. The concentration index (CI) was used to quantify the degree of inequality and the decomposition approach was applied to quantify the contributions from demographic factors to inequality in UTDFI coverage. The UTDFI coverage was 80.63% and the CI for UTDFI coverage was 0.12028 (95% CI: 0.10852-0.13175), indicating that immunization practice significantly favored children with relatively higher socio-economic status. The results of decomposition analysis suggested that 68.2% of the socio-economic inequality in UTDFI coverage should be explained by the mother's education level. Furthermore, factors such as birth order, ethnic group, maternal employment status, residence, immigration status, GDP per-capital and percentage of public health spending of the total health spending also could explain the disparity in UTDFI coverage. There exists inequality in UTDFI coverage among the socio-economic disadvantage children. Health interventions of narrowing the socio-economic inequality in UTDFI coverage will benefit from being supplemented with strategies aimed at poverty and illiteracy reduction.

Educational inequalities in ischaemic heart disease mortality in 44,000 Norwegian women and men: the influence of psychosocial and behavioural factors. The HUNT Study.

PubMed

Ernstsen, Linda; Bjerkeset, Ottar; Krokstad, Steinar

2010-11-01

To investigate the influence of psychosocial and behavioural factors on educational inequalities in ischaemic heart disease (IHD) mortality. A population-based cohort study of 44,128 women and men free of IHD aged 30 years and older at baseline in 1995-97. After adjustment for age and long-standing illness, both women (HR 3.22, 95% CI 1.31-7.90) and men (HR 1.57, 95% CI 1.03-2.40) who completed only primary education level (primary and lower secondary school) were at increased risk for IHD mortality compared to those who completed the tertiary education level (first and second stage of tertiary education). Behavioural factors explained 25% of the relative difference between primary and tertiary education level in IHD mortality among women and 53 % in men. Psychosocial factors had small influence on the relative difference in IHD mortality Findings from this study indicate that differences in behavioural factors contribute considerably more to inequalities in IHD mortality in educational levels than do psychosocial factors, and this effect seems to be stronger in men than women.

Explaining changes in child health inequality in the run up to the 2015 Millennium Development Goals (MDGs): The case of Zambia

PubMed Central

Hangoma, Peter; Aakvik, Arild; Robberstad, Bjarne

2017-01-01

Background Child health interventions were drastically scaled up in the period leading up to 2015 as countries aimed at meeting the 2015 target of the Millennium Development Goals (MDGs). MDGs were defined in terms of achieving improvements in average health. Significant improvements in average child health are documented, but evidence also points to rising inequality. It is important to investigate factors that drive the increasing disparities in order to inform the post-2015 development agenda of reducing inequality, as captured in the Sustainable Development Goals (SDGs). We investigated changes in socioeconomic inequality in stunting and fever in Zambia in 2007 and 2014. Unlike the huge literature that seeks to quantify the contribution of different determinants on the observed inequality at any given time, we quantify determinants of changes in inequality. Methods Data from the 2007 and 2014 waves of the Zambia Demographic and Health Survey (DHS) were utilized. Our sample consisted of children aged 0–5 years (n = 5,616 in 2007 and n = 12,714 in 2014). We employed multilevel models to assess the determinants of stunting and fever, which are two important child health indicators. The concentration index (CI) was used to measure the magnitude of inequality. Changes in inequality of stunting and fever were investigated using Oaxaca-type decomposition of the CI. In this approach, the change in the CI for stunting/fever is decomposed into changes in CI for each determinant and changes in the effect—measured as an elasticity—of each determinant on stunting/fever. Results While average rates of stunting reduced in 2014 socioeconomic inequality in stunting increased significantly. Inequality in fever incidence also increased significantly, but average rates of fever did not reduce. The increase in the inequality (CI) of determinants accounted for the largest part (42.5%) of the increase in inequality of stunting, while the increase in the effect of determinants explained 35% of the increase. The determinants with the greatest total contribution (change in CI plus change in effect) to the increase in inequality of stunting were mother’s height and weight, wealth, birth order, facility delivery, duration of breastfeeding, and maternal education. For fever, almost all (86%) the increase in inequality was accounted for by the increase in the effect of determinants of fever, while the distribution of determinants mattered less. The determinants with the greatest total contribution to the increase in inequality of fever were wealth, maternal education, birth order and breastfeeding duration. In the multilevel model, we found that the likelihood of a child being stunted or experiencing fever depends on the community in which they live. Conclusions To curb the increase in inequality of stunting and fever, policy may focus on improving levels of, and reducing inequality in, access to facility deliveries, maternal nutrition (which may be related to maternal weight and height), complementary feeding (for breastfed children), wealth, maternal education, and child care (related to birth order effects). Improving overall levels of these determinants contribute to the persistence of inequality if these determinants are unequally concentrated on the well off to begin with. PMID:28170442

Explaining changes in child health inequality in the run up to the 2015 Millennium Development Goals (MDGs): The case of Zambia.

PubMed

Hangoma, Peter; Aakvik, Arild; Robberstad, Bjarne

2017-01-01

Child health interventions were drastically scaled up in the period leading up to 2015 as countries aimed at meeting the 2015 target of the Millennium Development Goals (MDGs). MDGs were defined in terms of achieving improvements in average health. Significant improvements in average child health are documented, but evidence also points to rising inequality. It is important to investigate factors that drive the increasing disparities in order to inform the post-2015 development agenda of reducing inequality, as captured in the Sustainable Development Goals (SDGs). We investigated changes in socioeconomic inequality in stunting and fever in Zambia in 2007 and 2014. Unlike the huge literature that seeks to quantify the contribution of different determinants on the observed inequality at any given time, we quantify determinants of changes in inequality. Data from the 2007 and 2014 waves of the Zambia Demographic and Health Survey (DHS) were utilized. Our sample consisted of children aged 0-5 years (n = 5,616 in 2007 and n = 12,714 in 2014). We employed multilevel models to assess the determinants of stunting and fever, which are two important child health indicators. The concentration index (CI) was used to measure the magnitude of inequality. Changes in inequality of stunting and fever were investigated using Oaxaca-type decomposition of the CI. In this approach, the change in the CI for stunting/fever is decomposed into changes in CI for each determinant and changes in the effect-measured as an elasticity-of each determinant on stunting/fever. While average rates of stunting reduced in 2014 socioeconomic inequality in stunting increased significantly. Inequality in fever incidence also increased significantly, but average rates of fever did not reduce. The increase in the inequality (CI) of determinants accounted for the largest part (42.5%) of the increase in inequality of stunting, while the increase in the effect of determinants explained 35% of the increase. The determinants with the greatest total contribution (change in CI plus change in effect) to the increase in inequality of stunting were mother's height and weight, wealth, birth order, facility delivery, duration of breastfeeding, and maternal education. For fever, almost all (86%) the increase in inequality was accounted for by the increase in the effect of determinants of fever, while the distribution of determinants mattered less. The determinants with the greatest total contribution to the increase in inequality of fever were wealth, maternal education, birth order and breastfeeding duration. In the multilevel model, we found that the likelihood of a child being stunted or experiencing fever depends on the community in which they live. To curb the increase in inequality of stunting and fever, policy may focus on improving levels of, and reducing inequality in, access to facility deliveries, maternal nutrition (which may be related to maternal weight and height), complementary feeding (for breastfed children), wealth, maternal education, and child care (related to birth order effects). Improving overall levels of these determinants contribute to the persistence of inequality if these determinants are unequally concentrated on the well off to begin with.

Physical and psychosocial working conditions as explanations for occupational class inequalities in self-rated health.

PubMed

Kaikkonen, Risto; Rahkonen, Ossi; Lallukka, Tea; Lahelma, Eero

2009-10-01

Socio-economic health inequalities are well documented, but efforts to explain health inequalities are less. However, previous studies suggest that working conditions provide potential explanations for inequalities in health. Cross-sectional questionnaire survey data, collected from municipal employees of the City of Helsinki, aged 40-60 years (n = 8960, response rate 67%) in 2000-02, were examined using binomial regression analysis. Socio-economic position was measured by six occupational social classes ranging from top managers to manual workers, and the outcome was self-rated health (SRH). Key physical and psychosocial working conditions and work arrangements were included as explanatory factors for inequalities in health. Occupational class inequalities in SRH were clear among women [prevalence ratio (PR) 1.89, 95% confidence interval (CI) 1.54-2.32] and men (PR 1.78, 95% CI 1.40-2.25). Heavy physical workload explained a half of the health inequalities among women and almost one-third among men. Physical and chemical exposures at work explained one-fifth of the health inequalities among women and a half among men. Job control explained 24% of the men's and 40% of women's inequalities, whereas job demands widened the inequalities by 13-14%. The effects of shift work and working hours were negligible. In the fully adjusted model, 60% of the women's and 32% of the men's inequalities in SRH were explained. Physical working conditions explained a large part and job control, a somewhat smaller part of socio-economic inequalities in SRH. Improving physical working conditions and increasing job control provide potential routes to reduced inequalities in health among employees.

Are differential consumption patterns in health-related behaviours an explanation for persistent and widening social inequalities in health in England?

PubMed

Stait, Emma; Calnan, Michael

2016-10-18

During the last two decades, differential consumption patterns in health-related behaviours have increasingly been highlighted as playing an important role in explaining persistent and widening health inequalities. This period has also seen government public health policies in England place a greater emphasis on changing 'lifestyle' behaviours, in an attempt to tackle social inequalities in health. The aim of this study was to empirically examine the variation in health-related behaviour in relation to socio-economic position, in the English adult population, to determine the nature of this relationship and whether it has changed over time. The study population was derived from the Health Survey for England between 2001 and 2012 (n = 56,468). The relationships between health-related behaviour (smoking, fruit and vegetable intake, alcohol consumption and physical activity) and three socioeconomic indicators (educational level, occupational social class and equivilised household income) were analysed using log bi-nomial regression. The study found that each of the three socio-economic indicators were statistically related to smoking, fruit and vegetable consumption and alcohol intake, with the strongest relationship found for smoking. For physical activity, no relationship was found in 2003 by education or income and in 2008 by occupation. Statistical analysis showed that the difference between those at the highest and lowest end of the socio-economic indicators had widened in relation to smoking, as measured by educational level, occupation and household income. A similar trend was also found for physical activity as measured by educational level and household income. However, for fruit and vegetable intake and alcohol consumption, the relationship between health-related behaviour and socio-economic position had narrowed over time as measured by education and income. The findings provided only partial support for the thesis that socio-economic variations in health-related behaviours may be significant in explaining widening health inequalities. The significance of socio-economic variations in health-related behaviours might reflect both materialist and cultural explanations for socio-economic inequalities although it was not possible to separate and estimate the relative importance of these effects.

Decomposition of educational differences in life expectancy by age and causes of death among South Korean adults.

PubMed

Jung-Choi, Kyunghee; Khang, Young-Ho; Cho, Hong-Jun; Yun, Sung-Cheol

2014-06-05

Decomposition of socioeconomic inequalities in life expectancy by ages and causes allow us to better understand the nature of socioeconomic mortality inequalities and to suggest priority areas for policy and intervention. This study aimed to quantify age- and cause-specific contributions to socioeconomic differences in life expectancy at age 25 by educational level among South Korean adult men and women. We used National Death Registration records in 2005 (129,940 men and 106,188 women) and national census data in 2005 (15, 215, 523 men and 16,077,137 women aged 25 and over). Educational attainment as the indicator of socioeconomic position was categorized into elementary school graduation or less, middle or high school graduation, and college graduation or higher. Differences in life expectancy at age 25 by educational level were estimated by age- and cause-specific mortality differences using Arriaga's decomposition method. Differences in life expectancy at age 25 between college or higher education and elementary or less education were 16.23 years in men and 7.69 years in women. Young adult groups aged 35-49 in men and aged 25-39 in women contributed substantially to the differences between college or higher education and elementary or less education in life expectancy. Suicide and liver disease were the most important causes of death contributing to the differences in life expectancy in young adult groups. For older age groups, cerebrovascular disease and lung cancer were important to explain educational differential in life expectancy at 25-29 between college or higher education and middle or higher education. The contribution of the causes of death to socioeconomic inequality in life expectancy at age 25 in South Korea varied by age groups and differed by educational comparisons. The age specific contributions for different causes of death to life expectancy inequalities by educational attainment should be taken into account in establishing effective policy strategies to reduce socioeconomic inequalities in life expectancy.

Do biomass fuel use and consumption of unsafe water mediate educational inequalities in stillbirth risk? An analysis of the 2007 Ghana Maternal Health Survey

PubMed Central

Näyhä, Simo; Jaakkola, Jouni J K

2017-01-01

Background Numerous studies have explored the association between educational inequalities and stillbirth but most have failed to elaborate how low educational attainment leads to an increased risk of stillbirth. We hypothesised that use of biomass fuels and consumption of unsafe water related to low educational attainment could explain the stillbirth burden in Ghana attributable to socioeconomic disadvantage. Methods Data from the 2007 Ghana Maternal Health Survey, a nationally representative population-based survey were analysed for this study. Of the10 370 women aged 15–49 years interviewed via structured questionnaires for the survey, 7183 primiparous and multiparous women qualified for inclusion in the present study. Results In a logistic regression analysis that adjusted for age, area of residence, marital status and ethnicity of women, lower maternal primary education was associated with a 62% (OR=1.62; 95% CI 1.04 to 2.52) increased lifetime risk of stillbirth. Biomass fuel use and consumption of unsafe water mediated 18% and 8% of the observed effects, respectively. Jointly these two exposures explained 24% of the observed effects. The generalised additive modelling revealed a very flat inverted spoon-shaped smoothed curve which peaked at low levels of schooling (2–3 years) and confirms the findings from the logistic regression analysis. Conclusions Our results show that biomass fuel use and unsafe water consumption could be important pathways through which low maternal educational attainment leads to stillbirths in Ghana and similar developing countries. Addressing educational inequalities in developing countries is thus essential for ensuring household choices that curtail environmental exposures and help improve pregnancy outcomes. PMID:28174221

Sex differences in child and adolescent mortality by parental education in the Nordic countries.

PubMed

Gissler, Mika; Rahkonen, Ossi; Mortensen, Laust; Arntzen, Annett; Cnattingius, Sven; Nybo Andersen, Anne-Marie; Hemminki, Elina

2012-01-01

Socioeconomic position inequalities in infant mortality are well known, but there is less information on how child mortality is socially patterned by sex and age. To assess maternal and paternal socioeconomic inequalities in mortality by sex, whether these differences vary by age and country, and how much of the sex differences can be explained by external causes of death. Data on all live-born children were received from national birth registries for 1981-2000 (Denmark: n=1,184,926; Norway: n=1,090,127; and Sweden n=1,961,911) and for 1987-2000 (Finland: n=841,470). Data on the highest level of education in 2000 were obtained from national education registers, and data on mortality and causes of death were received from the national cause-of-death registers until the end of follow-up (20 years or 2003). Boys had a higher child and adolescent mortality than girls. The children of mothers and fathers who had had the shortest education time had the highest mortality for both sexes and for all ages and countries. The differences between the groups with longer than basic education were smaller, particularly among older children and girls. The gradient in mortality was mostly similar for boys and girls. Among 1-19-year-olds, 32% of boys' deaths and 27% of girls' deaths were due to external causes. Boys' excess mortality was only partly explained by educational inequalities or by deaths from external causes. A more detailed analysis is needed to study whether the share of avoidable deaths is higher among children whose parents have had a shorter education time.

Educational Attainment: Success to the Successful

ERIC Educational Resources Information Center

Anthony, Peter; Gould, David; Smith, Gina

2013-01-01

Systems archetypes are patterns of structure found in systems that are helpful in understanding some of the dynamics within them. The intent of this study was to examine educational attainment data using the success-to-the-successful archetype as a model to see if it helps to explain the inequality observed in the data. Data covering 1990 to 2009…

From "Culturally Deprived" to "At Risk": The Politics of Popular Expression and Educational Inequality in the United States, 1960-1985

ERIC Educational Resources Information Center

Martinez, Sylvia L. M.; Rury, John L.

2012-01-01

This article examines the terms "culturally deprived" and "disadvantaged" in light of their popular use in the sixties and following decades, particularly in the ethnic and mainstream press. These expressions represented an effort to explain differences in educational attainment and academic achievement along lines of social…

Education Inequalities in Health Among Older European Men and Women: The Role of Active Aging.

PubMed

Arpino, Bruno; Solé-Auró, Aïda

2017-08-01

We assessed whether education inequalities in health among older people can be partially explained by different levels of active aging among educational groups. We applied logistic regression and the Karlson, Holm, & Breen (KHB) decomposition method using the 2010 and 2012 waves of the Survey of Health, Ageing and Retirement in Europe on individuals aged 50+ years ( N = 27,579). Active aging included social participation, paid work, and provision of grandchild care. Health was measured by good self-perceived health, low number of depressive symptoms, and absence of limitations because of health in activities people usually do. We found a positive educational gradient for each of the three health measures. Up to a third of the health gaps between high and low educated were associated with differences in engagement in active aging activities. Policies devoted at stimulating an active participation in society among older people should be particularly focused on lower educated groups.

Is lower symptom recognition associated with socioeconomic inequalities in help-seeking for potential breast cancer symptoms?

PubMed

Davies, Hilary; Marcu, Afrodita; Vedsted, Peter; Whitaker, Katriina L

2018-02-01

Socioeconomic inequalities in recognising signs and symptoms of cancer may result in inequalities in timely help-seeking and subsequent prognosis of breast cancer. We explored the mediating role of symptom attribution and concern on the relationship between level of education and help-seeking for potential breast cancer symptoms. Women aged ≥47 years (n = 961) were purposively recruited (by education) to complete an online vignette-based survey that included nipple rash and axillary lump (in separate vignettes) as potential symptoms of breast cancer. Women completed questions relating to medical help-seeking (yes/no), cancer attribution, symptom concern, cancer avoidance, family history, and demographics. Women with low education and mid education attributed nipple rash less often to cancer (26% and 27% mentioned cancer) than women with a degree or higher (40%). However, women with a degree or higher (63%) or mid education (64%) were less likely to anticipate seeking help for the nipple rash than women with no formal qualifications (73%). This association was statistically significant in the 60- to 69-year-old age group. There was no significant association between education and help-seeking for axillary lump. Mediation analysis adjusting for potential confounders confirmed that the association between education and help-seeking for nipple rash was fully mediated by symptom concern. Socioeconomic inequalities in stage at diagnosis and survival of breast cancer may not always be explained by lower likelihood of suspecting cancer and subsequent impact on help-seeking. Reducing inequalities in stage at diagnosis will involve understanding a broader range of bio-psycho-social factors (eg, comorbidities and healthcare system factors). Copyright © 2017 John Wiley & Sons, Ltd.

Regional inequalities in self-rated health and disability in younger and older generations in Turkey: the contribution of wealth and education.

PubMed

Ergin, Isil; Kunst, Anton E

2015-09-29

In Turkey, large regional inequalities were found in maternal and child health. Yet, evidence on regional inequalities in adult health in Turkey remains fragmentary. This study aims to assess regional and rural/urban inequalities in the prevalence of poor self-rated health and in disability among adult populations in Turkey, and to measure the contribution of education and wealth of individual residents. The central hypothesis was that geographical inequalities in adult health exist even when the effect of education and wealth were taken into account. We analyzed data of the 2002 World Health Survey for Turkey on 10791 adults aged 20 years and over. We measured respondents' rating of their own general health and the prevalence of five types of physical disability. Logistic regression was used to estimate how much these two health outcomes varied according to urban/rural place of residence, region, education level and household wealth. We stratified the analyses by gender and age (‹50 and ≥50 years). Both health outcomes were strongly associated with educational level (especially for older age group) and with household wealth (especially for younger age group). Both health outcomes also varied according to region and rural/urban place of residence. Higher prevalence rates were observed in the East region (compared to West) with odd ratios varying between 1.40-2.76. After controlling for education and wealth, urban/rural differences in health disappeared, while regional differences were observed only among older women. The prevalence of poor self-rated health was higher for older women in the Middle (OR = 1.69), Black Sea (OR = 1.53) and East (OR = 2.06) regions. In Turkey, substantial geographical inequalities in self-reported adult health do exist, but can mostly be explained by differences in socioeconomic characteristics of residents. The regional disadvantage of older women in the East, Middle and Black Sea may have resulted from life-long exposure to gender discrimination under a patriarchal ideology. Yet, not geographic inequalities, but the more fundamental socioeconomic inequalities, are of key public health concern, also in Turkey.

Coronary angiography and myocardial revascularization following the first acute myocardial infarction in Norway during 2001-2009: Analyzing time trends and educational inequalities using data from the CVDNOR project.

PubMed

Sulo, Enxhela; Nygård, Ottar; Vollset, Stein Emil; Igland, Jannicke; Sulo, Gerhard; Ebbing, Marta; Egeland, Grace M; Hawkins, Nathaniel M; Tell, Grethe S

2016-06-01

We analyzed trends in the utilization of coronary angiography and revascularization - including percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) - related to the first AMI and explored potential educational inequalities in such procedures. All first AMI patients aged 35-89, hospitalized during 2001-2009 were retrieved from 'The Cardiovascular Disease in Norway' project. Information on education was obtained from The Norwegian Education Database. Gender and age group-specific trends in coronary procedures were analyzed using Joinpoint regression. Educational inequalities were explored using multivariable Poisson regression and reported as incidence rate ratios (IRR). A total of 104 836 patients (37.3% women) were included. Revascularization rates increased on average 9.0% and 15.4% per year among younger (35-64years) and older (65-89years) men. Corresponding increases among women were 5.6% and 16.6%. Compared to patients with primary education only, those with secondary and tertiary education had 8% (IRR=1.08, 95% CI; 1.06-1.10) and 12% (IRR=1.12, 95% CI; 1.09-1.14) higher revascularization rates. Educational inequalities were entirely driven by educational differences in receiving coronary angiography (IRR=1.10, 95% CI; 1.08-1.11 for secondary versus primary and IRR=1.14, 95% CI; 1.12-1.16 for tertiary versus primary education level.) Among diagnosed patients, no educational differences were observed in coronary revascularization rates. Revascularization rates increased whereas educational differences in revascularization decreased among AMI patients in Norway during 2001-2009. Lower coronary revascularization rates among patients with low education were explained by educational differences in receiving coronary angiography. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does psychosocial stress explain socioeconomic inequities in 9-year weight gain among young women?

PubMed

Ball, Kylie; Schoenaker, Danielle A J M; Mishra, Gita D

2017-06-01

This study investigated the contribution of psychosocial stress to mediating inequities in weight gain by educational status in a large cohort of young Australian women over a 9-year follow-up. This observational cohort study used survey data drawn from 4,806 women, aged 22 to 27 years at baseline (2000), participating in the Australian Longitudinal Study on Women's Health, who reported their education level (2000), perceived stress (2003), and weight (2003 and 2012). Using a causal inference framework based on counterfactuals for mediation analysis, we fitted linear or logistic regression models to examine the total effect, decomposed into natural direct and indirect effects via perceived stress, of education level (highest qualification completed: up to year 12/trade or diploma vs. university) on weight change. Women with lower education gained more weight over 9 years (6.1 kg, standard deviation [SD] 9.5) than women with higher education (3.8 kg, SD 7.7; P < 0.0001) and were more likely to be very or extremely stressed. The higher weight gain associated with low education was not mediated through perceived stress (per SD increase, percent mediated: 1.0%). Education-based inequities in weight gain over time were not attributable to greater psychosocial stress among women with lower education levels. © 2017 The Obesity Society.

Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries

PubMed Central

Conway, David I.; Brenner, Darren R.; McMahon, Alex D.; Macpherson, Lorna M.D.; Agudo, Antonio; Ahrens, Wolfgang; Bosetti, Cristina; Brenner, Hermann; Castellsague, Xavier; Chen, Chu; Curado, Maria Paula; Curioni, Otávio A.; Maso, Luigino Dal; Daudt, Alexander W.; de Gois Filho, José F.; D'Souza, Gypsyamber; Edefonti, Valeria; Fabianova, Eleonora; Fernandez, Leticia; Franceschi, Silvia; Gillison, Maura; Hayes, Richard B.; Healy, Claire M.; Herrero, Rolando; Holcatova, Ivana; Jayaprakash, Vijayvel; Kelsey, Karl; Kjaerheim, Kristina; Koifman, Sergio; La Vecchia, Carlo; Lagiou, Pagona; Lazarus, Philip; Levi, Fabio; Lissowska, Jolanta; Luce, Daniele; Macfarlane, Tatiana V.; Mates, Dana; Matos, Elena; McClean, Michael; Menezes, Ana M; Menvielle, Gwenn; Merletti, Franco; Morgenstern, Hal; Moysich, Kirsten; Müller, Heiko; Muscat, Joshua; Olshan, Andrew F.; Purdue, Mark P.; Ramroth, Heribert; Richiardi, Lorenzo; Rudnai, Peter; Schantz, Stimson; Schwartz, Stephen M.; Shangina, Oxana; Simonato, Lorenzo; Smith, Elaine; Stucker, Isabelle; Sturgis, Erich M.; Szeszenia-Dabrowska, Neonila; Talamini, Renato; Thomson, Peter; Vaughan, Thomas L.; Wei, Qingyi; Winn, Deborah M.; Wunsch-Filho, Victor; Yu, Guo-Pei; Zhang, Zuo-Feng; Zheng, Tongzhang; Znaor, Ariana; Boffetta, Paolo; Chuang, Shu-Chun; Ghodrat, Marianoosh; Lee, Yuan-Chin Amy; Hashibe, Mia; Brennan, Paul

2015-01-01

Low socioeconomic status has been reported to be associated with head and neck cancer risk. However, previous studies have been too small to examine the associations by cancer subsite, age, sex, global region and calendar time and to explain the association in terms of behavioral risk factors. Individual participant data of 23,964 cases with head and neck cancer and 31,954 controls from 31 studies in 27 countries pooled with random effects models. Overall, low education was associated with an increased risk of head and neck cancer (OR = 2.50; 95% CI = 2.02 – 3.09). Overall one-third of the increased risk was not explained by differences in the distribution of cigarette smoking and alcohol behaviors; and it remained elevated among never users of tobacco and nondrinkers (OR = 1.61; 95% CI = 1.13 – 2.31). More of the estimated education effect was not explained by cigarette smoking and alcohol behaviors: in women than in men, in older than younger groups, in the oropharynx than in other sites, in South/Central America than in Europe/North America and was strongest in countries with greater income inequality. Similar findings were observed for the estimated effect of low versus high household income. The lowest levels of income and educational attainment were associated with more than 2-fold increased risk of head and neck cancer, which is not entirely explained by differences in the distributions of behavioral risk factors for these cancers and which varies across cancer sites, sexes, countries and country income inequality levels. PMID:24996155

Obesity inequality in Malaysia: decomposing differences by gender and ethnicity using quantile regression.

PubMed

Dunn, Richard A; Tan, Andrew K G; Nayga, Rodolfo M

2012-01-01

Obesity prevalence is unequally distributed across gender and ethnic group in Malaysia. In this paper, we examine the role of socioeconomic inequality in explaining these disparities. The body mass index (BMI) distributions of Malays and Chinese, the two largest ethnic groups in Malaysia, are estimated through the use of quantile regression. The differences in the BMI distributions are then decomposed into two parts: attributable to differences in socioeconomic endowments and attributable to differences in responses to endowments. For both males and females, the BMI distribution of Malays is shifted toward the right of the distribution of Chinese, i.e., Malays exhibit higher obesity rates. In the lower 75% of the distribution, differences in socioeconomic endowments explain none of this difference. At the 90th percentile, differences in socioeconomic endowments account for no more than 30% of the difference in BMI between ethnic groups. Our results demonstrate that the higher levels of income and education that accrue with economic development will likely not eliminate obesity inequality. This leads us to conclude that reduction of obesity inequality, as well the overall level of obesity, requires increased efforts to alter the lifestyle behaviors of Malaysians.

Visual impairment and blindness in spanish adults: geographic inequalities are not explained by age or education.

PubMed

Rius, Anna; Artazcoz, Lucía; Guisasola, Laura; Benach, Joan

2014-01-01

The objectives of this study were to examine for the first time the prevalence of visual impairment and blindness among adults in Spain, to explore regional differences, and to assess whether they may vary as a function of sex or be explained by age and individual or regional socioeconomic position. Data were obtained from the 2008 Spanish Survey on Disability, Personal Autonomy, and Dependency Situations, a cross-sectional survey based on a representative sample of the noninstitutionalized population of Spain. The sample was composed of 213 626 participants aged ≥15 years (103 093 men and 110 533 women); 360 were blind (160 men and 200 women), 4048 had near visual impairment (1397 men and 2651 women), and 4034 had distance visual impairment (1445 men and 2589 women). The prevalence of near and distance visual impairment was calculated for each region. Multiple logistic regression models were fitted to calculate odds ratios and 95% confidence intervals. All analyses were stratified by sex. Visual impairment was based on 3 questions aimed at identifying blindness and near and distance visual impairment. The prevalence (percentage) of blindness was 0.17 (men, 0.16; women, 0.18): 1.89 for near visual impairment (men, 1.36; women, 2.40), 1.89 for distance visual impairment (men, 1.40; women, 2.34), and 2.43 for any visual impairment (men, 1.81; women, 3.02). Regional inequalities in the prevalence of visual impairment were observed, correlated with regional income, and the prevalence was consistently higher among women than men. The magnitude of the inequalities remained after adjusting for age and educational level, and a north-to-south pattern of increasing prevalence was observed. Regional and sex inequalities in the prevalence of visual impairment and blindness were observed in Spain, with a north-to-south gradient of increasing prevalence that was not explained by age or individual educational level but was correlated with regional level of economic development. Factors that could be prioritized for future policies and research include differential regional economic development, rural environment, quality of eye care services, diabetes, ultraviolet light exposure, or gender inequalities in diagnostic and therapeutic health care. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

New approaches for moving upstream: how state and local health departments can transform practice to reduce health inequalities.

PubMed

Freudenberg, Nicholas; Franzosa, Emily; Chisholm, Janice; Libman, Kimberly

2015-04-01

Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are "upstream" drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on "downstream" behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators' role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities. © 2015 Society for Public Health Education.

Social and diagnostic inequality in health.

PubMed

Bringedal, Berit; Tufte, Per Arne

2012-11-01

Empirical studies of social inequalities in health commonly take the diagnosing of disease for granted. Social inequalities in health are seen as the result of social processes, yet the diagnosis itself is rarely considered to contribute to such inequality. We argue that the influence of sociocultural and cognitive bias in the diagnosing process follows a social pattern, such that certain diagnoses are disproportionally over- or underrepresented in different socioeconomic groups due to interpretive bias of underlying symptoms. Norwegian data on sick leave for diffuse musculoskeletal and diffuse psychiatric disease in 2006 were analysed to study the distribution of the two diagnoses in different status groups. Socioeconomic status was measured by years of education. Diagnoses and occupational codes were based on national registers; diagnoses in accordance with the International Classification of Primary Care second edition. We compared occupations in technical sectors to occupations in the health sector and the relative number of cases of sick leave controlled for years of education, gender, occupational sector, and diagnosis. Data were analysed by cross-tabulation, ratio of diffuse psychiatric/musculoskeletal diseases, and logistic regression. The ratio of diffuse psychiatric/musculoskeletal diseases increases with education and decreases if the employee works in a technical job. The results challenge the traditional explanation that job features alone can explain the distribution of disease and suggest that a part of the persistent social inequality in health can be caused by the diagnosing process. In order to reach a better understanding of the processes behind the social inequalities in health, the diagnosing process itself should also be studied.

Social capital, income inequality and the social gradient in self-rated health in Latin America: A fixed effects analysis.

PubMed

Vincens, Natalia; Emmelin, Maria; Stafström, Martin

2018-01-01

Latin America is the most unequal region in the world. The current sustainable development agenda increased attention to health inequity and its determinants in the region. Our aim is to investigate the social gradient in health in Latin America and assess the effects of social capital and income inequality on it. We used cross-sectional data from the World Values Survey and the World Bank. Our sample included 10,426 respondents in eight Latin American countries. Self-rated health was used as the outcome. Education level was the socioeconomic position indicator. We measured social capital by associational membership, civic participation, generalized trust, and neighborhood trust indicators at both individual and country levels. Income inequality was operationalized using the Gini index at country-level. We employed fixed effects logistic regressions and cross-level interactions to assess the impact of social capital and income inequality on the heath gradient, controlling for country heterogeneity. Education level was independently associated with self-rated health, representing a clear social gradient in health, favoring individuals in higher socioeconomic positions. Generalized and neighborhood trust at country-level moderated the effect on the association between socioeconomic position and health, yet favoring individuals in lower socioeconomic positions, especially in lower inequality countries, despite their lower individual social capital. Our findings suggest that collective rather than individual social capital can impact the social gradient in health in Latin America, explaining health inequalities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neonatal Mortality and Inequalities in Bangladesh: Differential Progress and Sub-national Developments.

PubMed

Minnery, Mark; Firth, Sonja; Hodge, Andrew; Jimenez-Soto, Eliana

2015-09-01

A rapid reduction in under-five mortality has put Bangladesh on-track to reach Millennium Development Goal 4. Little research, however, has been conducted into neonatal reductions and sub-national rates in the country, with considerable disparities potentially masked by national reductions. The aim of this paper is to estimate national and sub-national rates of neonatal mortality to compute relative and absolute inequalities between sub-national groups and draw comparisons with rates of under-five mortality. Mortality rates for under-five children and neonates were estimated directly for 1980-1981 to 2010-2011 using data from six waves of the Demographic and Health Survey. Rates were stratified by levels of rural/urban location, household wealth and maternal education. Absolute and relative inequalities within these groups were measured by rate differences and ratios, and where possible, slope and relative indices of inequality. National mortality was shown to have decreased dramatically although at differential rates for under-fives and neonates. Across all equity markers, a general pattern of declining absolute but constant relative inequalities was found. For mortality rates stratified by education and wealth mixed evidence suggests that relative inequalities may have also fallen. Although disparities remain, Bangladesh has achieved a rare combination of substantive reductions in mortality levels without increases in relative inequalities. A coalescence of substantial increases in coverage and equitable distribution of key child and neonatal interventions with widespread health sectoral and policy changes over the last 30 years may in part explain this exceptional pattern.

Identifying health disparities across the tobacco continuum.

PubMed

Fagan, Pebbles; Moolchan, Eric T; Lawrence, Deirdre; Fernander, Anita; Ponder, Paris K

2007-10-01

Few frameworks have addressed work-force diversity, inequities and inequalities as part of a comprehensive approach to eliminating tobacco-related health disparities. This paper summarizes the literature and describes the known disparities that exist along the tobacco disease continuum for minority racial and ethnic groups, those living in poverty, those with low education and blue-collar and service workers. The paper also discusses how work-force diversity, inequities in research practice and knowledge allocation and inequalities in access to and quality of health care are fundamental to addressing disparities in health. We examined the available scientific literature and existing public health reports to identify disparities across the tobacco disease continuum by minority racial/ethnic group, poverty status, education level and occupation. Results indicate that differences in risk indicators along the tobacco disease continuum do not explain fully tobacco-related cancer consequences among some minority racial/ethnic groups, particularly among the aggregate groups, blacks/African Americans and American Indians/Alaska Natives. The lack of within-race/ethnic group data and its interactions with socio-economic factors across the life-span contribute to the inconsistency we observe in the disease causal paradigm. More comprehensive models are needed to understand the relationships among disparities, social context, diversity, inequalities and inequities. A systematic approach will also help researchers, practitioners, advocates and policy makers determine critical points for interventions, the types of studies and programs needed and integrative approaches needed to eliminate tobacco-related disparities.

Educational inequalities in TV viewing among older adults: a mediation analysis of ecological factors

PubMed Central

2013-01-01

Background Television (TV) viewing, a prevalent leisure-time sedentary behaviour independently related to negative health outcomes, appears to be higher in less educated and older adults. In order to tackle the social inequalities, evidence is needed about the underlying mechanisms of the association between education and TV viewing. The present purpose was to examine the potential mediating role of personal, social and physical environmental factors in the relationship between education and TV viewing among Australian 55–65 year-old adults. Methods In 2010, self-reported data was collected among 4082 adults (47.6% men) across urban and rural areas of Victoria, for the Wellbeing, Eating and Exercise for a Long Life (WELL) study. The mediating role of personal (body mass index [BMI], quality of life), social (social support from family and friends, social participation at proximal level, and interpersonal trust, social cohesion, personal safety at distal level) and physical environmental (neighbourhood aesthetics, neighbourhood physical activity environment, number of televisions) factors in the association between education and TV viewing time was examined using the product-of-coefficients test of MacKinnon based on multilevel linear regression analyses (conducted in 2012). Results Multiple mediating analyses showed that BMI (p ≤ 0.01), personal safety (p < 0.001), neighbourhood aesthetics (p ≤ 0.01) and number of televisions (p ≤ 0.01) partly explained the educational inequalities in older adult’s TV viewing. No proximal social factors mediated the education-TV viewing association. Conclusions Interventions aimed to reduce TV viewing should focus on personal (BMI) and environmental (personal safety, neighbourhood aesthetics, number of televisions) factors, in order to overcome educational inequalities in sedentary behaviour among older adults. PMID:24350830

Educational inequalities in TV viewing among older adults: a mediation analysis of ecological factors.

PubMed

De Cocker, Katrien; De Bourdeaudhuij, Ilse; Teychenne, Megan; McNaughton, Sarah; Salmon, Jo

2013-12-19

Television (TV) viewing, a prevalent leisure-time sedentary behaviour independently related to negative health outcomes, appears to be higher in less educated and older adults. In order to tackle the social inequalities, evidence is needed about the underlying mechanisms of the association between education and TV viewing. The present purpose was to examine the potential mediating role of personal, social and physical environmental factors in the relationship between education and TV viewing among Australian 55-65 year-old adults. In 2010, self-reported data was collected among 4082 adults (47.6% men) across urban and rural areas of Victoria, for the Wellbeing, Eating and Exercise for a Long Life (WELL) study. The mediating role of personal (body mass index [BMI], quality of life), social (social support from family and friends, social participation at proximal level, and interpersonal trust, social cohesion, personal safety at distal level) and physical environmental (neighbourhood aesthetics, neighbourhood physical activity environment, number of televisions) factors in the association between education and TV viewing time was examined using the product-of-coefficients test of MacKinnon based on multilevel linear regression analyses (conducted in 2012). Multiple mediating analyses showed that BMI (p ≤ 0.01), personal safety (p < 0.001), neighbourhood aesthetics (p ≤ 0.01) and number of televisions (p ≤ 0.01) partly explained the educational inequalities in older adult's TV viewing. No proximal social factors mediated the education-TV viewing association. Interventions aimed to reduce TV viewing should focus on personal (BMI) and environmental (personal safety, neighbourhood aesthetics, number of televisions) factors, in order to overcome educational inequalities in sedentary behaviour among older adults.

Inequalities in oral health among adolescents in Gangneung, South Korea.

PubMed

Jung, Se-Hwan; Kim, Myoung-Hee; Ryu, Jae-In

2018-04-24

This study aims to evaluate inequality in oral health among adolescents and to explain the mechanisms of such inequalities in Gangneung, South Korea. One thousand two hundred sixty-seven students in their first year from four vocational and three general schools participated in the baseline survey of 2011, and 84.7% of them were surveyed again in 2013. Oral examinations by the same dentist and a self-administered questionnaire were repeated during both waves. Outcome measure for oral health was the existence of untreated dental caries (DT). As socioeconomic position (SEP) indicators, school type (general vs. vocational), father's and mother's education, perceived economic status, and Family Affluence Scale (FAS) were measured. Variables measuring oral health related behaviours included tooth brushing frequency, frequency of eating snacks and drinking sodas, smoking, and annual visits to dental clinics. Chi-square tests and panel logistic regression were adopted to examine the associations between dental caries and SEP indicators by STATA version 15.1. Having a less educated father and attending a vocational school were significant predictors for untreated caries after controlling for SEP indicators. However, students from general schools, higher SEP by father's education, perceived economic status, or FAS, or having non-smoking experience or annual visits to dental clinics were more likely to stay caries-free. There were socioeconomic inequalities in oral health on an adolescent panel. Given that oral health status during adolescents can persist throughout the course of a person's life, intervention to tackle such inequalities and school environments are required.

Variations in the relation between education and cause-specific mortality in 19 European populations: a test of the "fundamental causes" theory of social inequalities in health.

PubMed

Mackenbach, Johan P; Kulhánová, Ivana; Bopp, Matthias; Deboosere, Patrick; Eikemo, Terje A; Hoffmann, Rasmus; Kulik, Margarete C; Leinsalu, Mall; Martikainen, Pekka; Menvielle, Gwenn; Regidor, Enrique; Wojtyniak, Bogdan; Östergren, Olof; Lundberg, Olle

2015-02-01

Link and Phelan have proposed to explain the persistence of health inequalities from the fact that socioeconomic status is a "fundamental cause" which embodies an array of resources that can be used to avoid disease risks no matter what mechanisms are relevant at any given time. To test this theory we compared the magnitude of inequalities in mortality between more and less preventable causes of death in 19 European populations, and assessed whether inequalities in mortality from preventable causes are larger in countries with larger resource inequalities. We collected and harmonized mortality data by educational level on 19 national and regional populations from 16 European countries in the first decade of the 21st century. We calculated age-adjusted Relative Risks of mortality among men and women aged 30-79 for 24 causes of death, which were classified into four groups: amenable to behavior change, amenable to medical intervention, amenable to injury prevention, and non-preventable. Although an overwhelming majority of Relative Risks indicate higher mortality risks among the lower educated, the strength of the education-mortality relation is highly variable between causes of death and populations. Inequalities in mortality are generally larger for causes amenable to behavior change, medical intervention and injury prevention than for non-preventable causes. The contrast between preventable and non-preventable causes is large for causes amenable to behavior change, but absent for causes amenable to injury prevention among women. The contrast between preventable and non-preventable causes is larger in Central & Eastern Europe, where resource inequalities are substantial, than in the Nordic countries and continental Europe, where resource inequalities are relatively small, but they are absent or small in Southern Europe, where resource inequalities are also large. In conclusion, our results provide some further support for the theory of "fundamental causes". However, the absence of larger inequalities for preventable causes in Southern Europe and for injury mortality among women indicate that further empirical and theoretical analysis is necessary to understand when and why the additional resources that a higher socioeconomic status provides, do and do not protect against prevailing health risks. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does Inequality in Skills Explain Inequality of Earnings across Advanced Countries? NBER Working Paper Series.

ERIC Educational Resources Information Center

Devroye, Dan; Freeman, Richard

The question of whether inequality in skills explains inequality of earnings across advanced countries was examined through a review of data from the International Adult Literacy Survey (IALS), which examined the prose, document, and quantitative literacy skills of adults in 12 member countries of the Organisation for Economic Cooperation and…

Social Inequality and Labor Force Participation.

ERIC Educational Resources Information Center

King, Jonathan

The labor force participation rates of whites, blacks, and Spanish-Americans, grouped by sex, are explained in a linear regression model fitted with 1970 U. S. Census data on Standard Metropolitan Statistical Area (SMSA). The explanatory variables are: average age, average years of education, vocational training rate, disabled rate, unemployment…

The Racial School-Climate Gap

ERIC Educational Resources Information Center

Voight, Adam

2013-01-01

Education inequity is a persistent reality of American culture. As early as kindergarten, there are marked differences in academic performance between racial minority students and their peers. These differences are sustained as students progress through school. One aspect of students' social experience that may help to explain the gap is school…

A General Critical Discourse Analysis Framework for Educational Research

ERIC Educational Resources Information Center

Mullet, Dianna R.

2018-01-01

Critical discourse analysis (CDA) is a qualitative analytical approach for critically describing, interpreting, and explaining the ways in which discourses construct, maintain, and legitimize social inequalities. CDA rests on the notion that the way we use language is purposeful, regardless of whether discursive choices are conscious or…

Country- and individual-level socioeconomic determinants of depression: multilevel cross-national comparison.

PubMed

Rai, Dheeraj; Zitko, Pedro; Jones, Kelvyn; Lynch, John; Araya, Ricardo

2013-03-01

The prevalence and correlates of depression vary across countries. Contextual factors such as country-level income or income inequalities have been hypothesised to contribute to these differences. To investigate associations of depression with socioeconomic factors at the country level (income inequality, gross national income) and individual (education, employment, assets and spending) level, and to investigate their relative contribution in explaining the cross-national variation in the prevalence of depression. Multilevel study using interview data of 187 496 individuals from 53 countries participating in the World Health Organization World Health Surveys. Depression prevalence varied between 0.4 and 15.7% across countries. Individual-level factors were responsible for 86.5% of this variance but there was also reasonable variation at the country level (13.5%), which appeared to increase with decreasing economic development of countries. Gross national income or country-level income inequality had no association with depression. At the individual level, fewer material assets, lower education, female gender, economic inactivity and being divorced or widowed were associated with increased odds of depression. Greater household spending, unlike material assets, was associated with increasing odds of depression (adjusted analysis). The variance of depression prevalence attributable to country-level factors seemed to increase with decreasing economic development of countries. However, country-level income inequality or gross national income explained little of this variation, and individual-level factors appeared more important than contextual factors as determinants of depression. The divergent relationship of assets and spending with depression emphasise that different socioeconomic measures are not interchangeable in their associations with depression.

Do biomass fuel use and consumption of unsafe water mediate educational inequalities in stillbirth risk? An analysis of the 2007 Ghana Maternal Health Survey.

PubMed

Amegah, A Kofi; Näyhä, Simo; Jaakkola, Jouni J K

2017-02-07

Numerous studies have explored the association between educational inequalities and stillbirth but most have failed to elaborate how low educational attainment leads to an increased risk of stillbirth. We hypothesised that use of biomass fuels and consumption of unsafe water related to low educational attainment could explain the stillbirth burden in Ghana attributable to socioeconomic disadvantage. Data from the 2007 Ghana Maternal Health Survey, a nationally representative population-based survey were analysed for this study. Of the10 370 women aged 15-49 years interviewed via structured questionnaires for the survey, 7183 primiparous and multiparous women qualified for inclusion in the present study. In a logistic regression analysis that adjusted for age, area of residence, marital status and ethnicity of women, lower maternal primary education was associated with a 62% (OR=1.62; 95% CI 1.04 to 2.52) increased lifetime risk of stillbirth. Biomass fuel use and consumption of unsafe water mediated 18% and 8% of the observed effects, respectively. Jointly these two exposures explained 24% of the observed effects. The generalised additive modelling revealed a very flat inverted spoon-shaped smoothed curve which peaked at low levels of schooling (2-3 years) and confirms the findings from the logistic regression analysis. Our results show that biomass fuel use and unsafe water consumption could be important pathways through which low maternal educational attainment leads to stillbirths in Ghana and similar developing countries. Addressing educational inequalities in developing countries is thus essential for ensuring household choices that curtail environmental exposures and help improve pregnancy outcomes. 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/.

Educational Inequality and Income Inequality: An Empirical Study on China

ERIC Educational Resources Information Center

Yang, Jun; Huang, Xiao; Li, Xiaoyu

2009-01-01

Based on the endogenous growth theory, this paper uses the Gini coefficient to measure educational inequality and studies the empirical relationship between educational inequality and income inequality through a simultaneous equation model. The results show that: (1) Income inequality leads to educational inequality while the reduction of…

Embodying pervasive discrimination: a decomposition of sexual orientation inequalities in health in a population-based cross-sectional study in Northern Sweden.

PubMed

Gustafsson, Per E; Linander, Ida; Mosquera, Paola A

2017-01-21

Studies from Sweden and abroad have established health inequalities between heterosexual and non-heterosexual people. Few studies have examined the underpinnings of such sexual orientation inequalities in health. To expand this literature, the present study aimed to employ decomposition analysis to explain health inequalities between people with heterosexual and non-heterosexual orientation in Sweden, a country with an international reputation for heeding the human rights of non-heterosexual people. Participants (N = 23,446) came from a population-based cross-sectional survey in the four northernmost counties in Sweden in 2014. Participants completed self-administered questionnaires, covering sexual orientation, mental and general physical health, social conditions and unmet health care needs, and sociodemographic data was retrieved from total population registers. Sexual orientation inequalities in health were decomposed by Blinder-Oaxaca decomposition analysis. Results showed noticeable mental and general health inequalities between heterosexual and non-heterosexual orientation groups. Health inequalities were partly explained (total explained fraction 64-74%) by inequalities in degrading treatment (24-26% of the explained fraction), but to a considerable degree also by material conditions (38-45%) and unmet care needs (25-43%). Psychosocial experiences may be insufficient to explain and understand health inequalities by sexual orientation in a reputedly 'gay-friendly' setting. Less overt forms of structural discrimination may need to be considered to capture the pervasive material discrimination that seems to underpin the embodiment of sexual minority inequalities. This ought to be taken into consideration in research, policy-making and monitoring aiming to work towards equity in health across sexual orientations.

Cross-national comparison of socioeconomic inequalities in obesity in the United States and Canada.

PubMed

Siddiqi, Arjumand; Brown, Rashida; Nguyen, Quynh C; Loopstra, Rachel; Kawachi, Ichiro

2015-10-31

Prior cross-national studies of socioeconomic inequalities in obesity have only compared summary indices of inequality but not specific, policy-relevant dimensions of inequality: (a) shape of the socioeconomic gradient in obesity, (b) magnitude of differentials in obesity across socioeconomic levels and, (c) level of obesity at any given socioeconomic level. We use unique data on two highly comparable societies - U.S. and Canada - to contrast each of these inequality dimensions. Data came from the 2002/2003 Joint Canada/U.S. Survey of Health. We calculated adjusted prevalence ratios (APRs) for obesity (compared to normal weight) by income quintile and education group separately for both nations and, between Canadians and Americans in the same income or education group. In the U.S., every socioeconomic group except the college educated had significant excess prevalence of obesity. By contrast in Canada, only those with less than high school were worse off, suggesting that the shape of the socioeconomic gradient differs in the two countries. U.S. differentials between socioeconomic levels were also larger than in Canada (e.g., PR quintile 1 compared to quintile 5 was 1.82 in the U.S. [95 % CI: 1.52-2.19] but 1.45 in Canada [95 % CI: 1.10-1.91]). At the lower end of the socioeconomic gradient, obesity was more prevalent in the U.S. than in Canada. Our results suggest there is variation between U.S. and Canada in different dimensions of socioeconomic inequalities in obesity. Future research should examine a broader set of nations and test whether specific policies or environmental exposures can explain these differences.

Understanding socio-economic inequalities in food choice behaviour: can Maslow's pyramid help?

PubMed

van Lenthe, Frank J; Jansen, Tessa; Kamphuis, Carlijn B M

2015-04-14

Socio-economic groups differ in their material, living, working and social circumstances, which may result in different priorities about their daily-life needs, including the priority to make healthy food choices. Following Maslow's hierarchy of human needs, we hypothesised that socio-economic inequalities in healthy food choices can be explained by differences in the levels of need fulfilment. Postal survey data collected in 2011 (67·2 % response) from 2903 participants aged 20-75 years in the Dutch GLOBE (Gezondheid en Levens Omstandigheden Bevolking Eindhoven en omstreken) study were analysed. Maslow's hierarchy of human needs (measured with the Basic Need Satisfaction Inventory) was added to age- and sex-adjusted linear regression models that linked education and net household income levels to healthy food choices (measured by a FFQ). Most participants (38·6 %) were in the self-actualisation layer of the pyramid. This proportion was highest among the highest education group (47·6 %). Being in a higher level of the hierarchy was associated with a higher consumption of fruits and vegetables as well as more healthy than unhealthy bread, snack and dairy consumption. Educational inequalities in fruit and vegetable intake (B= -1·79, 95 % CI -2·31, -1·28 in the lowest education group) were most reduced after the hierarchy of needs score was included (B= -1·57, 95 % CI - ·09, -1·05). Inequalities in other healthy food choices hardly changed after the hierarchy of needs score was included. People who are satisfied with higher-level needs make healthier food choices. Studies aimed at understanding socio-economic inequalities in food choice behaviour need to take differences in the priority given to daily-life needs by different socio-economic groups into account, but Maslow's pyramid offers little help.

[Social inequalities in adolescent smoking: A cross-national perspective of the role of individual and macro-structural factors].

PubMed

Pförtner, Timo-Kolja; Rathmann, Katharina; Moor, Irene; Kunst, Anton E; Richter, Matthias

2016-02-01

In an EU-funded project, we examined on the basis of international comparative analyses which factors were associated with and contributed to socioeconomic inequalities in adolescent smoking. This paper presents the results obtained and discusses their implications for policy and research. Analyses were based on the "Health Behaviour in School-aged Children (HBSC)" study in 2006 and included more than 50,000 adolescents from 37 countries. The focus was on the association between family affluence and weekly smoking (regularly, at least once a week) among adolescents. Explanatory variables at the individual level refer to psychosocial resources and burdens of school, family, and peers. At the country level, national income, various tobacco control policies, and an index of external differentiation of the educational system were used. The psychosocial factors of school and family explained many of the inequalities in the smoking behavior of adolescents. In an international comparison, socioeconomic inequalities in smoking were stronger in richer countries. Absolute smoking rates were lower and inequalities in smoking smaller for boys in countries with higher tobacco prices. On the other hand, educational systems with higher degrees of external differentiation showed lower inequalities in smoking beahviour by girls, and relatively higher rates of smoking (for boys and girls). Stronger inequalities in smoking behaviour were demonstrated in countries with a greater range of preventative measures for tobacco dependence (for boys) and with higher levels of government spending on tobacco control (for girls). Experiences in richer countries revealed that tobacco control needs to be strengthened for socially disadvantaged adolescents. The reduction of smoking prevalence and socioeconomic inequalities in smoking behavior should be based not only on a strengthening of psychosocial resources in the family and at school, but also on an increase in tobacco prices.

Cancer stage, comorbidity, and socioeconomic differences in the effect of cancer on labour market participation: a danish register-based follow-up study.

PubMed

Thielen, Karsten; Kolodziejczyk, Christophe; Andersen, Ingelise; Heinesen, Eskil; Diderichsen, Finn

2015-01-01

Socioeconomic inequality in return to work after cancer treatment and rehabilitation have been documented, but less is known about its causes. This paper investigates the role played by breast cancer stage at diagnosis and comorbidity. We used the comprehensive Danish Cancer Registry to follow 7372 women aged 30-60, who were in the labour force when diagnosed with breast cancer in 2000-06 and survived at least three years. Controls were 213,276 women without breast cancer. Inequalities in employment outlook were estimated as interaction effects in linear regression between educational attainment and disease on employment. There is significant interaction between education and breast cancer, but it is only marginally affected by including stage and comorbidity in the regression models. Education, breast cancer stage, and comorbidity all have strong effects on later employment, and a considerable amount of the educational effect is mediated by comorbidity and pre-cancer labour market participation and income. The result of the study is negative in the sense that the stronger effect of breast cancer on employment among low-educated compared to highly educated individuals is not explained by cancer stage or comorbidity. The fact that comorbidity has little impact on inequality may be due to a different social patterning of most comorbidity compared to breast cancer.

Sowing the seeds of change: social justice as praxis in undergraduate nursing education.

PubMed

Mohammed, Selina A; Cooke, Cheryl L; Ezeonwu, Mabel; Stevens, Christine A

2014-09-01

In undergraduate nursing curricula, the rhetoric of social justice has held more prominence than its operationalization. Although undergraduate education is a prime vehicle for fostering social change, articles that describe social justice as praxis in baccalaureate nursing curricula are relatively uncommon. Addressing this gap, we explain how four RN-to-BSN courses use social justice as a framework for instruction. The first two courses generate emancipatory knowledge and advocacy ideas among students by underscoring how privilege and oppression operate in society, as well as in the production of health inequities. The final two courses demonstrate how partnerships with communities can enhance student knowledge regarding structural barriers to health and health care and lead to actions that target those issues. Despite challenges that exist when implementing curricula on amending health inequities, nurse educators are urged to press onward in planting the seeds of social justice in their classrooms; suggestions are made for accomplishing this goal.

Faculty Salary Equity: Issues and Options. AIR 1993 Annual Forum Paper.

ERIC Educational Resources Information Center

Snyder, Julie K.; And Others

This paper presents a multi-phased approach to identifying and correcting gender-based salary inequities within institutions of higher education. The major steps in this approach involve: (1) determining if a problem situation exists by using a conceptually sound, objective procedure that does a legal and effective job of explaining faculty…

Enhancing Parent Leadership through Building Social and Intellectual Capital

ERIC Educational Resources Information Center

Bolivar, Jose M.; Chrispeels, Janet H.

2011-01-01

Inequality of access to educational resources by different social classes has been widely documented, and schools have instituted parent programs to ameliorate this situation. However, lacking are theoretically based studies that explain how and why a program may be effective in bringing about change. The authors studied a 12-week parent…

Reproducing (Dis)advantage: The Role of Family-Based, School-Based, and Cumulative-Based Processes

ERIC Educational Resources Information Center

Conner, Sonya

2012-01-01

Pierre Bourdieu's theory of cultural and social reproduction (Bourdieu 1973; Bourdieu and Passeron 1977) offers a model that can be used to explain the existence of persistent educational stratification in the United States, which contributes to perpetuation of social inequality, more generally. This theoretical model purports three…

Explaining Scientists' Plans for International Mobility from a Life Course Perspective

ERIC Educational Resources Information Center

Netz, Nicolai; Jaksztat, Steffen

2017-01-01

We identify factors influencing young scientists' plans for research stays abroad by embedding theories of social inequality, educational decision making, and migration into a life course framework. We test the developed model of international academic mobility by calculating a structural equation model using data from an online survey of…

Schooling and Industrialization in China: Gender Differences in School Enrollment

ERIC Educational Resources Information Center

Lee, Ming-Hsuan

2014-01-01

The rapid decrease in gender inequality in education over the past several decades in China has drawn significant attention in the existing literature. Several factors have been proposed or examined to explain this decrease. However, few studies have examined this topic from the perspective of the changing job structure and skill requirements in…

Minority Students' Responses to Racism: The Case of Cyprus

ERIC Educational Resources Information Center

Stevens, Peter A. J.; Charalambous, Panayiota; Mesaritou, Evgenia; Spyrou, Spyros; Van Praag, Lore; D'hondt, Fanny; Vervaet, Roselien; Van Houtte, Mieke

2016-01-01

While research has focused on the role of racism in (re)producing ethnic/racial inequalities in education, there is very little research that investigates how variability in minority students' responses to racism can be explained. By using an ecological approach to integrate existing research on actors' responses to racism, this study finds that…

Expansion, Differentiation, and the Persistence of Social Class Inequalities in British Higher Education

ERIC Educational Resources Information Center

Boliver, Vikki

2011-01-01

Conventional political wisdom has it that educational expansion helps to reduce socioeconomic inequalities of access to education by increasing equality of educational opportunity. The counterarguments of Maximally Maintained Inequality (MMI) and Effectively Maintained Inequality (EMI), in contrast, contend that educational inequalities tend to…

Smoking overrules many other risk factors for small for gestational age birth in less educated mothers.

PubMed

van den Berg, Gerrit; van Eijsden, Manon; Galindo-Garre, Francisca; Vrijkotte, Tanja G M; Gemke, Reinoud J B J

2013-07-01

Although there is convincing evidence for the association between small for gestational age (SGA) and socioeconomic status (SES), it is not known to what extent explanatory factors contribute to this association. To examine to what extent risk factors could explain educational inequalities in SGA. In this study fully completed data were available for 3793 pregnant women of Dutch origin from a population-based cohort (ABCD study). Path-analysis was conducted to examine the role of explanatory factors in the relation of maternal education to SGA. Low-educated pregnant women had a higher risk of SGA offspring compared to the high-educated women (OR 1.98, 95% CI 1.35-2.89). In path-analysis, maternal cigarette smoking and maternal height explained this association. Maternal age, hypertension, chronic disease, late entry into antenatal care, neighborhood income, underweight, environmental cigarette smoking, drug abuse, alcohol use, caffeine intake, fish intake, folic acid intake, anxiety, and depressive symptoms did not play a role in the association between maternal education and SGA birth. Among a large array of potential factors, the elevated risk of SGA birth among low-educated women appeared largely attributable to maternal smoking and to a lesser extent to maternal height. To reduce educational inequalities more effort is required to include low-educated women especially in prenatal intervention programs such as smoking cessation programs instead of effort into reducing other SGA-risk factors, though these factors might still be relevant at the individual level. Copyright © 2013 Elsevier Ltd. All rights reserved.

The role of birthplace and educational attainment on induced abortion inequalities.

PubMed

González-Rábago, Yolanda; Rodriguez-Alvarez, Elena; Borrell, Luisa N; Martín, Unai

2017-01-13

Induced abortion (IA) has shown social inequality related to birthplace and education with higher rates of IAs in immigrant and in less educated women relative to their native and highly educated counterparts. This study examined the independent and joint effects of birthplace and education on IA, repeated and IA performed during the 2nd trimester of pregnancy among women residing in the Basque Country, Spain. We conducted a cross-sectional population-based study of IA among women aged 25-49 years residing in the Basque Country, Spain, between 2011 and 2013. Log-binomial regression was used to quantify the independent and joint effects of birthplace and education attainment on all outcomes. Immigrant women exhibited higher probability of having an IAs (PR: 5.31), a repeated (PR: 7.23) or a 2nd trimester IAs (PR: 4.07) than women born in Spain. We observed higher probabilities for all outcomes among women with a primary or less education relative to those with a graduate education (All IAs PR: 2.51; repeated PR: 6.00; 2nd trimester PR: 3.08). However, no significant heterogeneity was observed for the effect of education on the association of birthplace with IAs, repeated or 2nd trimester IAs. Birthplace and education are key factors to explain not only an IA decision but also having a repeated or a 2nd trimester IA. However, the effects of birthplace and education may be independent from each other on these outcomes. A better understanding of these factors on IAs is needed when designing programs for sexual and reproductive health aimed to reduce inequalities among women.

The role of self-control and cognitive functioning in educational inequalities in adolescent smoking and binge drinking.

PubMed

Davies, Lisa E M; Kuipers, Mirte A G; Junger, Marianne; Kunst, Anton E

2017-09-16

Large differences in substance use between educational levels originate at a young age, but there is limited evidence explaining these inequalities. The aim of this study was to test whether a) smoking and binge drinking are associated with lower levels of self-control and cognitive functioning, and b) associations between educational track and smoking and binge drinking, respectively, are attenuated after controlling for self-control and cognitive functioning. This study used cross-sectional survey data of 15 to 20-year-olds (N = 191) from low, middle, and high educational tracks. We measured regular binge drinking and regular smoking (more than once a month), cognitive functioning (cognitive ability, reaction time and memory span), and self-control. Logistic regression models were used to assess the associations between educational track and smoking and binge drinking controlled for age, gender and social disadvantage, and for self-control and cognitive functioning. According to models that controlled for age, gender and social disadvantage only, respondents in the low educational track were more likely to drink heavily (OR = 3.25, 95% CI = 1.48-7.17) and smoke (OR = 5.74, 95% CI = 2.31-14.29) than adolescents in the high educational track. The association between educational track and binge drinking was hardly reduced after adjustment for self-control and cognitive ability (OR = 2.88, 95% CI = 1.09-7.62). Adjustment for self-control and cognitive functioning, especially cognitive ability, weakened the association between education and smoking (OR = 3.40, 95% CI = 1.11-10.37). However, inequalities in smoking remained significant and substantial. In this study population, pre-existing variations between adolescents in terms of self-control and cognitive functioning played a minor role in educational inequalities in smoking, but not in binge drinking.

Disability and ageing in China and India - decomposing the effects of gender and residence. Results from the WHO study on global AGEing and adult health (SAGE).

PubMed

Stewart Williams, Jennifer; Norström, Fredrik; Ng, Nawi

2017-08-31

China and India are the world's two most populous countries. Although their populations are growing in number and life expectancies are extending they have different trajectories of economic growth, epidemiological transition and social change. Cross-country comparisons can allow national and global insights and provide evidence for policy and decision-making. The aim of this study is to measure and compare disability in men and women, and in urban and rural dwellers in China and India, and assess the extent to which social and other factors contribute to the inequalities. National samples of adults aged 50 to 79 years in China (n = 11,694) and India (n = 6187) from the World Health Organization (WHO) longitudinal Study on global AGEing and adult health (SAGE) Wave 1 were analysed. Stratified multiple linear regressions were undertaken to assess disability differences by sex and residence, controlling for other biological and socioeconomic determinants of disability. Oaxaca-Blinder decomposition partitioned the two-group inequalities into explained and unexplained components. In both countries women and rural residents reported more disability. In India, the gender inequality is attributed to the distribution of the determinants (employment, education and chronic conditions) but in China about half the inequality is attributed to the same. In India, more than half of the urban rural inequality is attributed to the distribution of the determinants (education, household wealth) compared with under 20% in China. Education and employment were important drivers of these measured inequalities. Overall inequalities in disability among older adults in China and India were shaped by gender and residence, suggesting the need for policies that target women and rural residents. There is a need for further research, using both qualitative and quantitative methods, to question and challenge entrenched practices and institutions and grasp the implications of global economic and social changes that are impacting on population health and ageing in China and India.

Is socioeconomic status a predictor of mortality in nonagenarians? The vitality 90+ study.

PubMed

Enroth, Linda; Raitanen, Jani; Hervonen, Antti; Nosraty, Lily; Jylhä, Marja

2015-01-01

socioeconomic inequalities in mortality are well-known in middle-aged and younger old adults, but the situation of the oldest old is less clear. The aim of this study was to investigate socioeconomic inequalities for all-cause, cardiovascular and dementia mortality among the people aged 90 or older. the data source was a mailed survey in the Vitality 90+ study (n = 1,276) in 2010. The whole cohort of people 90 years or over irrespective of health status or dwelling place in a geographical area was invited to participate. The participation rate was 79%. Socioeconomic status was measured by occupation and education, and health status by functioning and comorbidity. All-cause and cause-specific mortality was followed for 3 years. The Cox regression, with hazard ratios (HR) and 95% confidence intervals (CI), was applied. the all-cause and dementia mortality differed by occupational class. Upper non-manuals had lower all-cause mortality than lower non-manuals (HR: 1.61; 95% CI: 1.11-2.32), skilled manual workers (HR: 1.56 95% CI: 1.09-2.25), unskilled manual workers (HR: 1.88; 95% CI: 1.20-2.94), housewives (HR: 1.77 95% CI: 1.15-2.71) and those with unknown occupation (HR: 2.33; 95% CI: 1.41-3.85). Inequalities in all-cause mortality were largely explained by the differences in functioning. The situation was similar according to education, but inequalities were not statistically significant. Socioeconomic differences in cardiovascular mortality were not significant. socioeconomic inequalities persist in mortality for 90+-year-olds, but their magnitude varies depending on the cause of death and the indicator of socioeconomic status. Mainly, mortality differences are explained by differences in functional status. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Framing a Transdisciplinary Research Agenda in Health Education to address Health Disparities and Social Inequities: a road map for SOPHE action.

PubMed

Gambescia, Stephen F; Woodhouse, Lynn D; Auld, M Elaine; Green, B Lee; Quinn, Sandra Crouse; Airhihenbuwa, Collins O

2006-08-01

SOPHE leaders continue to challenge us to be true to the call for an "open society." SOPHE has supported the Healthy People 2010 goal of eliminating health disparities through its Strategic Plan. SOPHE held an Inaugural Health Education Research Disparities Summit, Health Disparities and Social Inequities: Framing a Transdisciplinary Research Agenda in Health Education, August 8 and 9, 2005. This article explains the process used at the Summit where more than 80 researchers, academicians, practitioners, and students from across the country convened to ask fundamental questions about health disparity associated with race and ethnicity and how a health education research agenda could help in eliminating these disparities. From this Summit, about a dozen questions and/or recommendations have been developed to frame our future discussions about health disparities. Through its Research Agenda Committee, SOPHE has developed a process of translation and dissemination, including community participation, review, dialogue, and action.

Social determinants of self-reported health in women and men: understanding the role of gender in population health.

PubMed

Hosseinpoor, Ahmad Reza; Stewart Williams, Jennifer; Amin, Avni; Araujo de Carvalho, Islene; Beard, John; Boerma, Ties; Kowal, Paul; Naidoo, Nirmala; Chatterji, Somnath

2012-01-01

Women and men share similar health challenges yet women report poorer health. The study investigates the social determinants of self-reported health in women and men, and male-female differences in health. Data on 103154 men and 125728 women were analysed from 57 countries in the World Health Survey 2002-2004. Item Response Theory was used to construct a composite measure of health. Associations between health and determinants were assessed using multivariate linear regression. Blinder-Oaxaca decomposition partitioned the inequality in health between women and men into an "explained" component that arises because men and women differ in social and economic characteristics, and an "unexplained" component due to the differential effects of these characteristics. Decomposition was repeated for 18 countries in the World Health Organization (WHO) African region and 19 countries in the WHO European region. Women's health was significantly lower than men's. Health was associated with education, household economic status, employment, and marital status after controlling for age. In the pooled analysis decomposition showed that 30% of the inequality was "explained", of which almost 75% came from employment, education, marital status. The differential effects of being in paid employment increased the inequality. When countries in Africa and Europe were compared, the "explained" component (31% and 39% respectively) was largely attributed to the social determinants in the African countries and to women's longevity in the European countries. Being in paid employment had a greater positive effect on the health of males in both regions. Ways in which age and the social determinants contribute to the poorer health status of women compared with men varies between groups of countries. This study highlights the need for action to address social structures, institutional discrimination and harmful gender norms and roles that differently influence health with ageing.

[Income-related health inequalities in France in 2004: Decomposition and explanations].

PubMed

Tubeuf, S

2009-10-01

This analysis supplements existing work on social health inequalities at two levels: the measurement of health and the measurement of inequalities. Firstly, individual health status was measured using a subjective health indicator corrected within a promising cardinalisation method which had not yet been carried out on French data. Secondly, this study used an innovative methodology to measure income-related health inequalities, to understand the relationships between income, income inequality, various social determinants, and health. The analysis was based on a sample of working-age adults from the 2004 Health and Health Insurance Survey. The methodology used in the study measures the total income-related health inequality using the concentration index. This index is based on a linear model explaining health according to several individual characteristics, such as age, sex, and various socioeconomic characteristics. The method thus takes into account both the causal relationships between the various explicative factors introduced in the model and their relationship with health. Furthermore, it concretely measures the contribution of the social determinants to income-related health inequalities. The results show an income-related health inequality favouring individuals with a higher income. Moreover, income level, supplementary private health insurance, education level, and social class account for the main contributions to inequality. Therefore, the decomposition method highlights population groups that policies should target. The study suggests that reducing income inequality is not sufficient to lower income-related health inequalities in France in 2004 and needs to be supplemented with the reduction of the relationship between income and health and the reduction of income inequality over socioeconomic status.

Socioeconomic inequalities in frailty and frailty components among community-dwelling older citizens

PubMed Central

van Grieken, Amy; Qin, Li; Melis, René J. F.; Rietjens, Judith A. C.; Raat, Hein

2017-01-01

Background So far, it has not yet been studied whether socioeconomic status is associated with distinct frailty components and for which frailty component this association is the strongest. We aimed to examine the association between socioeconomic status and frailty and frailty components. In addition we assessed the mediating effect of the number of morbidities on the association between socioeconomic status and other frailty components. Methods This is a cross-sectional study of pooled data of The Older Persons and Informal Caregivers Survey Minimum DataSet in the Netherlands among community-dwelling persons aged 55 years and older (n = 26,014). Frailty was measured with a validated Frailty Index that consisted of 45 items. The Frailty Index contained six components: morbidities, limitations in activities of daily living (ADL), limitations in instrumental ADL (IADL), health-related quality of life, psychosocial health and self-rated health. Socioeconomic indicators used were education level and neighbourhood socioeconomic status. Results Persons with primary or secondary education had higher overall frailty and frailty component scores compared to persons with tertiary education (P < .001). Lower education levels were most consistently associated with higher overall frailty, more morbidities and worse self-rated health (P < .05 in all age groups). The strongest association was found between primary education and low psychosocial health for persons aged 55–69 years and more IADL limitations for persons aged 80+ years. Associations between neighborhood socioeconomic status and frailty (components) also showed inequalities, although less strong. The number of morbidities moderately to strongly mediated the association between socioeconomic indicators and other frailty components. Conclusion There are socioeconomic inequalities in frailty and frailty components. Inequalities in frailty, number of morbidities and self-rated health are most consistent across age groups. The number of morbidities a person has play an important role in explaining socioeconomic inequalities in frailty and should be taken into account in the management of frailty. PMID:29121677

Income inequality and happiness.

PubMed

Oishi, Shigehiro; Kesebir, Selin; Diener, Ed

2011-09-01

Using General Social Survey data from 1972 to 2008, we found that Americans were on average happier in the years with less national income inequality than in the years with more national income inequality. We further demonstrated that this inverse relation between income inequality and happiness was explained by perceived fairness and general trust. That is, Americans trusted other people less and perceived other people to be less fair in the years with more national income inequality than in the years with less national income inequality. The negative association between income inequality and happiness held for lower-income respondents, but not for higher-income respondents. Most important, we found that the negative link between income inequality and the happiness of lower-income respondents was explained not by lower household income, but by perceived unfairness and lack of trust.

Exposure To Harmful Workplace Practices Could Account For Inequality In Life Spans Across Different Demographic Groups.

PubMed

Goh, Joel; Pfeffer, Jeffrey; Zenios, Stefanos

2015-10-01

The existence of important socioeconomic disparities in health and mortality is a well-established fact. Many pathways have been adduced to explain inequality in life spans. In this article we examine one factor that has been somewhat neglected: People with different levels of education get sorted into jobs with different degrees of exposure to workplace attributes that contribute to poor health. We used General Social Survey data to estimate differential exposures to workplace conditions, results from a meta-analysis that estimated the effect of workplace conditions on mortality, and a model that permitted us to estimate the overall effects of workplace practices on health. We conclude that 10-38 percent of the difference in life expectancy across demographic groups can be explained by the different job conditions their members experience. Project HOPE—The People-to-People Health Foundation, Inc.

Not Just "Study Drugs" for the Rich: Stimulants as Moral Tools for Creating Opportunities for Socially Disadvantaged Students.

PubMed

Ray, Keisha Shantel

2016-06-01

An argument in the cognitive enhancement literature is that using stimulants in populations of healthy but socially disadvantaged individuals mistakenly attributes pathology to nonpathological individuals who experience social inequalities. As the argument goes, using stimulants as cognitive-enhancing drugs to solve the social problem of poorly educated students in inadequate schools misattributes the problem as an individual medical problem, when it is really a collective sociopolitical problem. I challenge this argument on the grounds that not all types of enhancement have to be explained in medical terms, but rather at least one conception of enhancement can be explained in social terms-opportunity maintenance. Therefore, I propose that as a moral requirement we ought to explore whether stimulants could be a means of remedying underprivileged children's experiences of social inequalities that are borne from inadequate schools for the sake of increasing their chances for opportunities and well-being.

Education level and inequalities in stroke reperfusion therapy: observations in the Swedish stroke register.

PubMed

Stecksén, Anna; Glader, Eva-Lotta; Asplund, Kjell; Norrving, Bo; Eriksson, Marie

2014-09-01

Previous studies have revealed inequalities in stroke treatment based on demographics, hospital type, and region. We used the Swedish Stroke Register (Riksstroke) to test whether patient education level is associated with reperfusion (either or both of thrombolysis and thrombectomy) treatment. We included 85 885 patients with ischemic stroke aged 18 to 80 years registered in Riksstroke between 2003 and 2009. Education level was retrieved from Statistics Sweden, and thrombolysis, thrombectomy, patient, and hospital data were obtained from Riksstroke. We used multivariable logistic regression to analyze the association between reperfusion therapy and patient education. A total of 3649 (4.2%) of the patients received reperfusion therapy. University-educated patients were more likely to be treated (5.5%) than patients with secondary (4.6%) or primary education (3.6%; P<0.001). The inequality associated with education was still present after adjustment for patient characteristics; university education odds ratio, 1.14; 95% confidence interval, 1.03 to 1.26 and secondary education odds ratio, 1.08; 95% confidence interval, 1.00 to 1.17 compared with primary education. Higher hospital specialization level was also associated with higher reperfusion levels (P<0.001). In stratified multivariable analyses by hospital type, significant treatment differences by education level existed only among large nonuniversity hospitals (university education odds ratio, 1.20; 95% confidence interval, 1.04-1.40; secondary education odds ratio, 1.14; 95% confidence interval, 1.01-1.29). We demonstrated a social stratification in reperfusion, partly explained by patient characteristics and the local hospital specialization level. Further studies should address treatment delays, stroke knowledge, and means to improve reperfusion implementation in less specialized hospitals. © 2014 American Heart Association, Inc.

Intra-Provincial Inequality in Financing Compulsory Education in China: Exploring the Role of Provincial Leaders (1994-2001)

ERIC Educational Resources Information Center

Lin, Tingjin

2009-01-01

Elitism argues that the values and experiences of the political elite shape policy, while institutionalism contends that an individual's behaviour is constrained by institutional settings. This article shows that both perspectives work well overall, while offering persuasive arguments, but the former is dominated by the latter. This explains the…

The Search for Equity in School Funding. Education Partners Working Papers.

ERIC Educational Resources Information Center

Crampton, Faith; Whitney, Terry

After decades of media attention, study, and lawsuits, the solution to inequities in school funding remains elusive. This paper examines several strategies that states have used to try to close the funding disparities in per-pupil spending. It explains the two definitions of equity in the school-finance arena and identifies some important trends…

Socioeconomic inequalities in adult obesity risk in Canada: trends and decomposition analyses.

PubMed

Hajizadeh, Mohammad; Campbell, M Karen; Sarma, Sisira

2014-03-01

This study examines trends in socioeconomic-related inequalities in obesity risk among Canadian adults (aged 18-65 years) from 2000 to 2010 using five nationally representative Canadian Community Health Surveys (CCHSs). We employed the concentration index (C) to quantify the socioeconomic inequalities in obesity risk across different demographic groups and geographic regions in each survey period. A decomposition analysis of inequality is performed to determine factors that lie behind income-related inequality in obesity risk. Although declining over time, the results show that there exists income-related inequality in obesity risk in Canada. The estimated Cs for men indicate that obesity is concentrated among the rich and its trend is increasing over time. The findings, however, suggest that obesity is more prevalent among economically disadvantaged women. While we found that obesity is mainly concentrated among the poor in the Atlantic Provinces, the degree of socioeconomic related inequality in obesity risk is increasing in these provinces. The results for Alberta showed that obesity is concentrated among the better-off individuals. The decomposition analysis suggests that factors such as demographics, income, immigration, education, drinking habits, and physical activity are the key factors explaining income-related inequality in obesity risk in Canada. Our empirical findings suggest that, in order to combat the obesity epidemic, health policies should focus on poorer females and economically well-off males.

How much of the income inequality effect can be explained by public policy? Evidence from oral health in Brazil.

PubMed

Celeste, Roger Keller; Nadanovsky, Paulo

2010-10-01

To evaluate the association between income inequality, a public policy scale and to oral health. Analysis, using the Brazilian oral health survey in 2002-2003, included 23,573 15-19-year-old subjects clustered in 330 municipalities. Missing and decayed teeth and malocclusion assessments were the outcomes. Gini coefficient and a novel Scale of Municipal Public Policies were the main exposure variables. Individual level covariates were used as controls in multilevel regressions. An increase from the lowest to the highest Gini value in Brazil was associated with an increase in the number of missing (rate ratio, RR=2.11 confidence interval 95% 1.18-3.77) and decayed teeth (RR=2.92 CI 95% 1.83-4.65). After adjustment for public policies and water fluoridation, the Gini effect was non-significant and public policies explained most of the variation in missing and decayed teeth. The public policy scale remained significant after adjustment with a rate ratio of 0.64 for missing and 0.72 for decayed teeth. Neither Gini nor public policies were significantly related to malocclusion. The public policy effect on missing and decayed teeth was stronger among those with higher education and income. Income inequality effect was explained mainly by public policies, which had an independent effect that was greater among the better-off. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Relationships between income inequality and health: a study on rural and urban regions of Canada.

PubMed

Vafaei, Afshin; Rosenberg, Mark W; Pickett, William

2010-01-01

Many studies have demonstrated that health is a function of relative and not absolute income within populations. Canadian studies are not conclusive; most indicate that there is no relationship between income inequality and health within Canada. There is a need for further investigation into the validity of the 'relative income' hypothesis in the Canadian population. The primary objective of this research was to test the 'relative income' hypothesis across Canadian health regions. The second objective was to extend the hypothesis to consider rural versus urban populations. This research involved ecological analyses. The source of the data was the Canadian Community Health Survey, Cycle 3.1. The units of analysis were Canadian health regions. Health of a region was estimated as the percentage of people who rated their health as good or excellent. The primary exposure variable was the ratio of people whose personal income was less than $15,000 relative to those reporting more than $80,000 in the year preceding the survey. This ratio provided a measure of the distribution of income. The main covariates were ecological measures of socio-demographic variables, social capital, substance use behaviours (smoking and alcohol consumption), rural/urban status of the region, and absolute income in the region. Correlation analyses and multiple linear regressions were performed to ascertain the relationship between income inequality and population health, adjusting for important covariates. The measure of income inequality alone appeared to explain 18% of the variability in the measure of population health. However, after adding the measure of absolute income to the model, although 29% of the variability was explained, the independent contribution of the inequality measure became non-significant. Linear regression models suggested that the absolute income variable alone could explain 30% of the variance in the health status of populations. Other variables with a statistically significant contribution to the final model were education and alcohol consumption. The effect of rural/urban geographic status on the relationship of interest was similar to other covariates. This variable did not change the individual relationship between income inequality or absolute income and the measure of population health status. In both rural and urban regions, absolute income and education had positive effects on population health. In urban regions alcohol consumption was a significant negative contributor to population health status; whereas, in rural regions, smoking status had a significant negative effect on population health status. Across Canadian health regions, health status in populations was a function of absolute income but not relative income. Regions with higher levels of education had better levels of self-rated health. A larger percentage of heavy drinkers was also correlated with lower population health status. Findings were consistently observed in rural and urban populations. The study findings have implications for public health, economic, and social policies.

Trends in the prevalence, awareness, treatment, and control of cardiovascular risk factors across educational level in the 1995-2005 period.

PubMed

Redondo, Ana; Benach, Joan; Subirana, Isaac; Martinez, José Miguel; Muñoz, Miguel Angel; Masiá, Rafel; Ramos, Rafael; Sala, Joan; Marrugat, Jaume; Elosua, Roberto

2011-08-01

To determine the differences and trends in the prevalence, awareness, treatment and control of cardiovascular risk factors and lifestyle variables across educational level in the 1995-2005 period in a country with a universal free health care system. Data from three consecutive independent population-based surveys were used. Cardiovascular risk factors, lifestyle variables, and self-reported educational level were collected in 9646 individuals ages 35-74 years throughout the decade. The prevalence of hypertension and diabetes was inversely associated with education. An increase in the proportion of hypertension and dyslipidemia awareness, treatment, and control in all educational level groups was observed. This increase was greater among the lowest education group, reducing the disparities between groups. The prevalence of lifestyle-related risk factors decreased in the greatest but increased in the lowest education group, widening the disparities between groups. A universal free health care system is effective in avoiding inequalities in the diagnosis, treatment, and control of cardiovascular risk factors. However, other social determinants seem to explain the social inequalities in the prevalence of these risk factors and in the adoption of healthy lifestyles. Copyright © 2011 Elsevier Inc. All rights reserved.

Racial and Regional Inequalities in School Resources Relative to Their Educational Outcomes.

ERIC Educational Resources Information Center

McPartland, James M.; Sprehe, J. Timothy

This paper uses the data from the 1966 Educational Opportunities Survey (EOS) to investigate regional and racial inequalities in education by applying a definition of inequalities that incorporates both school inputs and educational outcomes. Inequalities in school inputs are weighted by their importance for educational outputs, in order to…

Persistent Inequality: Changing Educational Attainment in Thirteen Countries. Social Inequality Series.

ERIC Educational Resources Information Center

Shavit, Yossi, Ed.; Blossfeld, Hans-Peter, Ed.

This book encompasses a systematic, comparative study of change in educational stratification in 13 industrialized countries, exploring which societal conditions help reduce existing inequalities in educational opportunity. The contributors show that in most industrialized countries inequalities in educational opportunity among students from…

Students' Choice of Post-Compulsory Science: In Search of Schools that Compensate for the Socio-Economic Background of Their Students

ERIC Educational Resources Information Center

Anderhag, Per; Emanuelsson, Patrik; Wickman, Per-Olof; Hamza, Karim Mikael

2013-01-01

It is commonly argued that socio-economic inequalities can explain many of the differences in achievement and participation in science education that have been reported among countries and among schools within a country. We addressed this issue by examining (a) the relationship between variables associated with socio-economic background and…

Trends in Ethnic Inequality in the Attainment of Vocational Degrees: A Cohort Study in Germany

ERIC Educational Resources Information Center

Schuller, Karin

2018-01-01

The present article analyzes the development of the ethnic gap--with respect to the attainment of vocational degrees--over the immigration cohorts 1960-2001 by examining how social integration indicators and general secondary school education may help to explain the trend. It was found that the gap between natives and migrants increased. Above…

Educational assortative mating and income inequality in Denmark.

PubMed

Breen, Richard; Andersen, Signe Hald

2012-08-01

Many writers have expressed a concern that growing educational assortative mating will lead to greater inequality between households in their earnings or income. In this article, we examine the relationship between educational assortative mating and income inequality in Denmark between 1987 and 2006. Denmark is widely known for its low level of income inequality, but the Danish case provides a good test of the relationship between educational assortative mating and inequality because although income inequality increased over the period we consider, educational homogamy declined. Using register data on the exact incomes of the whole population, we find that change in assortative mating increased income inequality but that these changes were driven by changes in the educational distributions of men and women rather than in the propensity for people to choose a partner with a given level of education.

The role of communication inequality in mediating the impacts of socioecological and socioeconomic disparities on HIV/AIDS knowledge and risk perception.

PubMed

Bekalu, Mesfin Awoke; Eggermont, Steven

2014-02-10

Although the link between social factors and health-related outcomes has long been widely acknowledged, the mechanisms characterizing this link are relatively less known and remain a subject of continued investigation across disciplines. In this study, drawing on the structural influence model of health communication, the hypothesis that differences in concern about and information needs on HIV/AIDS, HIV/AIDS-related media use, and perceived salience of HIV/AIDS-related information, characterized as communication inequality, can at least partially mediate the impacts of socioecological (urban vs. rural) and socioeconomic (education) disparities on inequalities in HIV/AIDS knowledge and risk perception was tested. Data were collected from a random sample of 986 urban and rural respondents in northwest Ethiopia. Structural equation modeling, using the maximum likelihood method, was used to test the mediation models. The models showed an adequate fit of the data and hence supported the hypothesis that communication inequality can at least partially explain the causal mechanism linking socioeconomic and socioecological factors with HIV/AIDS knowledge and risk perception. Both urbanity versus rurality and education were found to have significant mediated effects on HIV/AIDS knowledge (urbanity vs. rurality: β = 0.28, p = .001; education: β = 0.08, p = .001) and HIV/AIDS risk perception (urbanity vs. rurality: β = 0.30, p = .001; education: β = 0.09, p = .001). It was concluded that communication inequality might form part of the socioecologically and socioeconomically embedded processes that affect HIV/AIDS-related outcomes. The findings suggest that the media and message effects that are related to HIV/AIDS behavior change communication can be viewed from a structural perspective that moves beyond the more reductionist behavioral approaches upon which most present-day HIV/AIDS communication campaigns seem to be based.

[Social inequalities in the mortality due to cardiovascular diseases in Italy].

PubMed

Costa, G; Cadum, E; Faggiano, F; Cardano, M; Demaria, M

1999-06-01

Social inequalities in cardiovascular disease mortality are described in this paper focusing on the results of the Studio Longitudinale Torinese (SLT), an investigation that links census data with the statistical data that are currently available. The overall results confirm that cardiovascular disease mortality is higher in less-advantaged socioeconomic groups, irrespectively of the social indicator used: education, social class, housing quality, job security. Stratified data shows less important inequalities among ischemic heart disease as compared to cerebrovascular mortality. The differences are even more complex when the age groups in the two genders are analyzed, revealing cohort effects. Overall, the results agree with the previous survey carried out by ISTAT on 1981 Italian mortality, which confirmed the variations in inequalities according to geographical areas, gender and age. Differences in access to the health system are likely to be related to the differences detected for geographical areas, while differences in personal history and attitude towards health-associated behavior should explain age and gender variations in inequalities. Equity must be included in the evaluation of preventive programs and health-care models. Epidemiological and social research should be encouraged to better understand the factors that influence inequalities in cardiovascular disease mortality and in the health status of the population at large.

The mediating effect of effort-reward imbalance in household and family work on the relationship between education and women's health.

PubMed

Sperlich, Stefanie; Geyer, Siegfried

2015-04-01

Occupational stress as a key determinant for explaining health inequalities has been well established while the impact of stress related to family work has rarely been considered. This study investigates whether stress in household and family work may contribute to health inequalities in women. We used a population-based sample of German mothers (n = 3129) to determine the total, direct and indirect effects of education on somatic complaints by means of OLS regression-based mediation models. Inference about indirect effects was determined by 95% bias corrected bootstrap confidence intervals. Education was assessed by a measure combining school education and vocational training. Stress was measured using the adopted effort-reward-imbalance (ERI) questionnaire for household and family work. The von Zerssen list of somatic complaints was used as measure of subjective health. We found a significant total effect of education on somatic complaints (p ≤ 0.001) as well as significant indirect effects through 'effort' (p = 0.006) and 'reward' in household and family work (p ≤ 0.001). However, the subscales of ERI pointed into different directions: while levels of 'effort' increased with women's educational attainment, levels of distress related to low 'reward' decreased with higher levels of education. Our findings suggest that the effect of women's education on somatic complaints is mediated through stress related to low reward for household and family work. In particular, lack of 'societal esteem' for household and family work contributed to health disadvantages in lower educated mothers. We conclude that research on health inequality would benefit from taking stressful experiences in household and family work greater into account. Copyright © 2015 Elsevier Ltd. All rights reserved.

Education's Effect on Income Inequality: An Economic Globalisation Perspective

ERIC Educational Resources Information Center

Wells, Ryan

2006-01-01

Utilising a globalisation framework this study contributes to discussions concerning inequality, education, and development by re-examining the effects of educational and economic variables on income inequality. This research shows that the effects of education on income inequality are affected by the level of economic freedom in a country, and…

Explaining the Widening Education Gap in Mortality among U.S. White Women

PubMed Central

Montez, Jennifer Karas; Zajacova, Anna

2013-01-01

Over the last half century the gap in mortality across education levels grew in the United States, and since the mid-1980s the growth was especially pronounced among white women. The reasons for the growth among white women are unclear. We investigated three explanations—social-psychological factors, economic circumstances, and health behaviors—for the widening education gap in mortality across 1997-2006 among white women 45-84 years of age. We used data from the National Health Interview Survey Linked Mortality File (N=46,744; deaths=4,053). We found little support for social-psychological factors; however, economic circumstances and health behaviors jointly explained the growing education gap in mortality to statistical nonsignificance. Employment and smoking were the most important individual components. Increasing high school graduation rates, reducing smoking prevalence, and designing work-family policies that help women find and maintain desirable employment may reduce mortality inequalities among women. PMID:23723344

Explaining the widening education gap in mortality among U.S. white women.

PubMed

Montez, Jennifer Karas; Zajacova, Anna

2013-06-01

Over the past half century the gap in mortality across education levels has grown in the United States, and since the mid-1980s, the growth has been especially pronounced among white women. The reasons for the growth among white women are unclear. We investigated three explanations-social-psychological factors, economic circumstances, and health behaviors-for the widening education gap in mortality from 1997 to 2006 among white women aged 45 to 84 years using data from the National Health Interview Survey Linked Mortality File (N = 46,744; 4,053 deaths). Little support was found for social-psychological factors, but economic circumstances and health behaviors jointly explained the growing education gap in mortality to statistical nonsignificance. Employment and smoking were the most important individual components. Increasing high school graduation rates, reducing smoking prevalence, and designing work-family policies that help women find and maintain desirable employment may reduce mortality inequalities among women.

Health Inequalities through the Lens of Health Capital Theory: Issues, Solutions, and Future Directions

PubMed Central

Galama, Titus J.; van Kippersluis, Hans

2013-01-01

We explore what health-capital theory has to offer in terms of informing and directing research into health inequality. We argue that economic theory can help in identifying mechanisms through which specific socioeconomic indicators and health interact. Our reading of the literature, and our own work, leads us to conclude that non-degenerate versions of the Grossman model (1972a;b) and its extensions can explain many salient stylized facts on health inequalities. Yet, further development is required in at least two directions. First, a childhood phase needs to be incorporated, in recognition of the importance of childhood endowments and investments in the determination of later-life socioeconomic and health outcomes. Second, a unified theory of joint investment in skill (or human) capital and in health capital could provide a basis for a theory of the relationship between education and health. PMID:24570580

Education-Related Gender Differences in Health in Rural China

PubMed Central

Wu, Jing; Liu, Yuanli; Rao, Keqin; Sun, Qi; Qian, Juncheng; Li, Zhu

2004-01-01

We investigated gender differences in education-related health inequalities in rural China. Household interview data were obtained from 6 provinces in 1993 and 2001. Remarkable health inequalities existed and favored the higher educational groups; among women, the inequalities were greater and health inequalities increased from 1993 to 2001. Education serves as a more powerful mediating factor for health inequalities among women than among men in rural China. PMID:15451739

Social inequality in health: dichotomy or gradient? A comparative study of problematizations in national public health programmes.

PubMed

Vallgårda, Signild

2008-01-01

Recent public health programmes from four countries: Denmark, England, Norway, and Sweden, are studied to analyse how social inequality in health is described, explained and suggested to be tackled, i.e., the problematization or the discursive process whereby the issue is framed and made accessible to political action. Social inequality in health is defined in these programmes both as a disadvantaged minority with major health problems, in contrast to the rest of the population, i.e., as a dichotomy; and as a gradient in which health problems are seen as increasing with lower social class or educational level. The causes of health inequality are identified as behaviour, social relations and underlying social structures. Policies aimed at reducing health inequality can be characterized as either in accordance with a residual welfare state model, targeting the disadvantaged, or a universal model, addressing the whole population. All countries have policies that are mixtures of these problematizations, but with some systematic differences between the countries. In this field England resembles the Scandinavian countries, as much as they resemble each other dispelling the idea of a Nordic or Scandinavian welfare state model.

Inequality in malnutrition by maternal education levels in early childhood: the Prospective Cohort of Thai Children (PCTC).

PubMed

Hong, Seo Ah; Winichagoon, Pattanee; Mongkolchati, Aroonsri

2017-05-01

As tackling socioeconomic inequality in child malnutrition still remains one of the greatest challenges in developing countries, we examined maternal educational differences in malnutrition and the magnitude of its inequality among 4,198 children from the Prospective Cohort study of Thai Children (PCTC). Prevalence of stunting, underweight, and wasting from birth to 24 months was calculated using the new WHO growth chart. The Relative Index of Inequality (RII) was used to examine the magnitude and trend of inequality in malnutrition between maternal educational levels. The low education group had lower weight and height in most ages than the high education group. Faltering in height was observed in all education levels, but was most remarkable in the low education group. On the other hand, while upward trends for weight-for-age and weight-for-height across ages were observed in the high education group, a marked decline between 6 to 12 months was observed in the low education group. An increasing trend in inequality in The RII revealed an increasing trend in inequality in stunting, underweight, and wasting by maternal education levels was observed during infancy with an almost monotonic increase until 24 months, although the inequality in wasting decreased after 18 months of age. Inequality in malnutrition remarkably increased during infancy, and for stunting and underweight it remained until 24 months. These findings shed light on the extent of malnutrition inequality during the first 2 years of life and they suggest sustainable efforts must be established at the national level to tackle the malnutrition inequality in infancy.

Trends in Educational Inequality in Different Eras (1940-2010)--A Re-Examination of Opportunity Inequalities in Urban-Rural Education

ERIC Educational Resources Information Center

Chunling, Li

2015-01-01

Based on national sampling survey data from 2006, 2008, and 2011, the author uses the Mare educational transition model to systematically examine changing trends in inequalities in urban-rural educational opportunities at all educational stages from 1940 to 2010. Through a comparative analysis of five birth year groups, inequalities in urban-rural…

Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia - a decomposition analysis approach.

PubMed

Pujilestari, Cahya Utamie; Nyström, Lennarth; Norberg, Margareta; Weinehall, Lars; Hakimi, Mohammad; Ng, Nawi

2017-12-12

Obesity has become a global health challenge as its prevalence has increased globally in recent decades. Studies in high-income countries have shown that obesity is more prevalent among the poor. In contrast, obesity is more prevalent among the rich in low- and middle-income countries, hence requiring different focal points to design public health policies in the latter contexts. We examined socioeconomic inequalities in abdominal obesity in Purworejo District, Central Java, Indonesia and identified factors contributing to the inequalities. We utilised data from the WHO-INDEPTH Study on global AGEing and adult health (WHO-INDEPTH SAGE) conducted in the Purworejo Health and Demographic Surveillance System (HDSS) in Purworejo District, Indonesia in 2010. The study included 14,235 individuals aged 50 years and older. Inequalities in abdominal obesity across wealth groups were assessed separately for men and women using concentration indexes. Decomposition analysis was conducted to assess the determinants of socioeconomic inequalities in abdominal obesity. Abdominal obesity was five-fold more prevalent among women than in men (30% vs. 6.1%; p < 0.001). The concentration index (CI) analysis showed that socioeconomic inequalities in abdominal obesity were less prominent among women (CI = 0.26, SE = 0.02, p < 0.001) compared to men (CI = 0.49, SE = 0.04, p < 0.001). Decomposition analysis showed that physical labour was the major determinant of socioeconomic inequalities in abdominal obesity among men, explaining 47% of the inequalities, followed by poor socioeconomic status (31%), ≤ 6 years of education (15%) and current smoking (11%). The three major determinants of socioeconomic inequalities in abdominal obesity among women were poor socio-economic status (48%), physical labour (17%) and no formal education (16%). Abdominal obesity was more prevalent among older women in a rural Indonesian setting. Socioeconomic inequality in abdominal obesity exists and concentrates more among the rich population in both sexes. The inequality gap is less prominent among women, indicating a trend towards obesity being more common in poor women. Policies to address social determinants of health need to be developed to address the socioeconomic inequality gaps in obesity, with particular focus on addressing the existing burden of obesity among the better-off population group, while preventing the imminent burden of obesity among the worst-off group, particularly among women.

Psychosocial work factors and social inequalities in psychological distress: a population-based study.

PubMed

Duchaine, Caroline S; Ndjaboué, Ruth; Levesque, Manon; Vézina, Michel; Trudel, Xavier; Gilbert-Ouimet, Mahée; Dionne, Clermont E; Mâsse, Benoît; Pearce, Neil; Brisson, Chantal

2017-01-18

Mental health problems (MHP) are the leading cause of disability worldwide. The inverse association between socioeconomic position (SEP) and MHP has been well documented. There is prospective evidence that factors from the work environment, including adverse psychosocial work factors, could contribute to the development of MHP including psychological distress. However, the contribution of psychosocial work factors to social inequalities in MHP remains unclear. This study evaluates the contribution of psychosocial work factors from two highly supported models, the Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models to SEP inequalities of psychological distress in men and women from a population-based sample of Quebec workers. Data were collected during a survey on working conditions, health and safety at work. SEP was evaluated using education, occupation and household income. Psychosocial work factors and psychological distress were assessed using validated instruments. Mean differences (MD) in the score of psychological distress were estimated separately for men and women. Low education level and low household income were associated with psychological distress among men (MD, 0.56 (95% CI 0.06; 1.05) and 1.26 (95% CI 0.79; 1.73) respectively). In men, the contribution of psychosocial work factors from the DCS and the ERI models to the association between household income and psychological distress ranged from 9% to 24%. No clear inequalities were observed among women. These results suggest that psychosocial work factors from the DCS and the ERI models contribute to explain a part of social inequalities in psychological distress among men. Psychosocial factors at work are frequent and modifiable. The present study supports the relevance of targeting these factors for the primary prevention of MHP and for health policies aiming to reduce social inequalities in mental health.

Social inequality in adolescents' healthy food intake: the interplay between economic, social and cultural capital.

PubMed

De Clercq, Bart; Abel, Thomas; Moor, Irene; Elgar, Frank J; Lievens, John; Sioen, Isabelle; Braeckman, Lutgart; Deforche, Benedicte

2017-04-01

Current explanations of health inequalities in adolescents focus on behavourial and economic determinants and rarely include more meaningful forms of economic, cultural, and social capital. The aim of the study was to investigate how the interplay between capitals constitutes social inequalities in adolescent healthy food intake. Data were collected in the 2013/14 Flemish Health Behavior among School-aged Children (HBSC) survey, which is part of the international WHO HBSC survey. The total sample included 7266 adolescents aged 12-18. A comprehensive set of 58 capital indicators was used to measure economic, cultural and social capital and a healthy food index was computed from a 17-item food frequency questionnaire (FFQ) to assess the consumption frequency of healthy food within the overall food intake. The different forms of capital were unequally distributed in accordance with the subdivisions within the education system. Only half of the capital indicators positively related to healthy food intake, and instead 17 interactions were found that both increased or reduced inequalities. Cultural capital was a crucial component for explaining inequalities such that social gradients in healthy food intake increased when adolescents participated in elite cultural practices ( P < 0.05), and were consequently reduced when adolescents reported to have a high number of books at home ( P < 0.05). A combination of selected resources in the form of economic, cultural and social capital may both increase or reduce healthy food intake inequalities in adolescents. Policy action needs to take into account the unequal distribution of these resources within the education system. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Economic Inequality, Educational Inequity, and Reduced Career Opportunity: A Self-Perpetuating Cycle?

ERIC Educational Resources Information Center

Torraco, Richard

2018-01-01

Economic inequality--the income gap between the wealthy and the poor--is increasing. Educational inequity has also increased with low-income students less likely to complete college than their wealthier counterparts. As the gap widens between the education "haves" and "have-nots," those with inadequate education are faced with…

Social inequality in chronic disease outcomes.

PubMed

Nordahl, Helene

2014-11-01

Socioeconomic differences in morbidity and mortality, particularly across educational groups, are widening. Differential exposures to behavioural risk factors have been shown to play an important mediating role on the social inequality in chronic diseases such as heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, and lung cancer. However, much less attention has been given to the potential role of interaction, where the same level of exposure to a behavioural risk factor has different effect across socioeconomic groups, creating subgroups that are more vulnerable than others. In this thesis, Paper 1 describes the unique cohort consortium which was established by pooling and harmonising prospective data from existing cohort studies in Denmark. This consortium generated a large study population with long follow-up sufficient to study power demanding questions of mechanisms underlying social inequalities in chronic disease outcomes. In Paper 2 on incidence of coronary heart disease, smoking and body mass index partially mediated the observed educational differences. This result suggested that some of the social inequality in coronary heart disease may be enhanced by differential exposure to behavioural risk factors (i.e. smoking and obesity). In Paper 3 on incidence of stroke, an observed interaction between education and smoking indicated that participants, particularly men, with low level of education may be more vulnerable to the effect of smoking than those with high level of education in terms of ischemic stroke. Finally, Paper 4 revealed that behavioural risk factors, primarily smoking, explained a considerable part of the educational differences in cause-specific mortality. Further, this paper added important knowledge about the considerable part of the mediated effect, which could be due to interaction between education and smoking. In conclusion, the research in this thesis is a practical implementation of contemporary statistical methodology, the additive hazards models, in which the potential role of behavioural risk factors can be regarded not only as mediation but also as interaction with the effect of socioeconomic position on chronic disease outcomes. The results support that two central mechanisms, differential exposure and differential vulnerability to behavioural risk factors, particularly smoking; have contributed substantially to the social inequality in chronic disease outcomes in Denmark. These mechanism are not mutually exclusive and should be regarded simultaneously. However, the findings could be non-causal associations due to, for instance, psychosocial or environmental factors. Nevertheless, research on social inequality in chronic disease outcomes should regard not only that the smoking prevalence is higher in lower socioeconomic groups (differential exposure), but also that health consequences of being a smoker seem to be worse in these subgroups (differential vulnerability).

EDUCATIONAL OPPORTUNITIES FOR BOYS AND GIRLS IN THAILAND

PubMed Central

Curran, Sara R.; Chung, Chang Y.; Cadge, Wendy; Varangrat, Anchalee

2016-01-01

Within individual countries, the paths towards increasing educational attainment are not always linear and individuals are not equally affected. Differences between boys’ and girls’ educational attainments are a common expression of this inequality as boys are more often favored for continued schooling. We examine the importance of birth cohort, sibship size, migration, and school accessibility for explaining both the gender gap and its narrowing in secondary schooling in one district in Northeast Thailand between 1984–1994. Birth cohort is a significant explanation for the narrowing of the gender gap. Migration, sibship size, and remote village location are important explanations for limited secondary education opportunities, especially for girls. PMID:27570492

Income-related and educational inequality in small-for-gestational age and preterm birth in Denmark and Finland 1987-2003.

PubMed

Mortensen, Laust H; Lauridsen, Jørgen T; Diderichsen, Finn; Kaplan, George A; Gissler, Mika; Andersen, Anne-Marie N

2010-02-01

In this paper, we examine income- and education-related inequality in small-for-gestational age (SGA) and preterm birth in Denmark and Finland from 1987 to 2003 using concentration indexes (CIXs). From the national medical birth registries we gathered information on all births from 1987 to 2003. Information on highest completed maternal education and household income in the year preceding birth of the offspring was obtained for 1,012,400 births in Denmark and 499,390 in Finland. We then calculated CIXs for income- and education-related inequality in SGA and preterm birth. The mean household income-related inequality in SGA was -0.04 (95% confidence interval: -0.05, -0.04) in Denmark and -0.03 (-0.04, -0.02) in Finland. The maternal education-related inequality in SGA was -0.08 (-0.10, -0.06) in Denmark and -0.07 (-0.08, -0.06) in Finland. The income-related inequality in preterm birth was -0.03 (-0.03, -0.02) in Denmark and -0.03 (-0.04, -0.02) in Finland. The education-related inequality in preterm birth was -0.05 (-0.07, -0.04) in Denmark and -0.04 (-0.05, -0.03) in Finland. In Denmark, the income-related and education-related inequity in SGA increased over time. In Finland, the income-related inequality in SGA birth increased slightly, while education-related inequalities remained stable. Inequalities in preterm birth decreased over time in both countries. Denmark and Finland are examples of nations with free prenatal care and publicly financed obstetric care of high quality. During the period of study there were macroeconomic shocks affecting both countries. However, only small income- and education-related inequalities in SGA and preterm births during the period were observed.

Economic inequality in presenting near vision acuity in a middle-aged population: a Blinder-Oaxaca decomposition.

PubMed

Emamian, Mohammad Hassan; Zeraati, Hojjat; Majdzadeh, Reza; Shariati, Mohammad; Hashemi, Hassan; Jafarzadehpur, Ebrahim; Fotouhi, Akbar

2013-09-01

To investigate economic inequality and its determinants in near vision, in a middle-aged population. In this population-based study, the presenting near vision in the better eye was investigated as the main outcome. If this vision revealed a value ≥1.6 M, the participant was considered to have presenting near vision impairment (PNVI). The effect of variables studied on PNVI was investigated using logistic regression. Economic inequality in PNVI was investigated using the Oaxaca-Blinder decomposition method. PNVI in the better eye was observed in 18.2% (95% CI 16.8 to 19.6) of participants. The prevalence of PNVI in the high and low economic groups was 11.7% (95% CI 10.3 to 13.0) and 28.5% (95% CI 26.0 to 31.0), respectively. Age and education were observed as the main factors in the explained portion of this gap and were in favour of the high economic group. Gender and eye care utilisation were factors affecting the unexplained portion of this gap and were in favour of the low economic group. Economic inequality plays a significant role in PNVI, while age and education are among the main factors affecting this gap. The effect caused by any change in these two factors was found to have a greater effect on women with low economic status.

An Analysis of Citizenship and Democracy Education Text Book in the Context of Gender Equality and Determining Students' Perceptions on Gender Equality

ERIC Educational Resources Information Center

Kalayci, Nurdan; Hayirsever, Fahriye

2014-01-01

Gender equality has been explained as both the equal treatment of women and men before the law and women's and men's equal usage of resources, opportunities, and services within the family and society. Today, although the conditions that support gender inequality have relatively decreased, gender discrimination still persists. Gender equality is…

Educational inequality in cardiovascular disease depends on diagnosis: A nationwide register based study from Denmark.

PubMed

Christensen, Anne V; Koch, Mette B; Davidsen, Michael; Jensen, Gorm B; Andersen, Lisbeth V; Juel, Knud

2016-05-01

Social inequality is present in the morbidity as well as the mortality of cardiovascular diseases. This paper aims to quantify and compare the level of educational inequality across different cardiovascular diagnoses. Register based study. Comparison of the extent of inequality across different cardiovascular diagnoses requires a measure of inequality which is comparable across subgroups with different educational distributions. The slope index of inequality and the relative index of inequality were applied for measuring inequalities in incidence of six cardiovascular diagnoses: ischaemic heart disease, acute myocardial infarction, valvular heart disease, congestive heart failure, atrial fibrillation and stroke in the period 2005-2009. All individuals in the general Danish population aged 35-84 years were followed in national registers regarding hospitalisation, death and education from 1985 to 2009 (annual average of 2.9 million people) to define incident cases. Marked educational inequality was found in the incidence of ischaemic heart disease, acute myocardial infarction, heart failure and stroke (relative index of inequality: 0.37 (95% confidence interval 0.34; 0.40) to 0.60 (0.57; 0.63), absolute index of inequality: -241 (-254.4; -227.4) to -37 (-42.7; -31.1)) while inequality in atrial fibrillation and, in particular, in valvular heart disease was small and insignificant (relative index of inequality: 0.57 (0.49; 0.65) to 0.97 (0.88; 1.08), absolute index of inequality: -29 (-35.1; -21.9) to -1 (-4.8; -3.8)). The degree of educational inequality in cardiovascular diseases depends on the diagnosis, with the highest inequality in ischaemic heart disease, acute myocardial infarction, heart failure and stroke. Small differences were found between men and women. © The European Society of Cardiology 2015.

Income Inequality Explains Why Economic Growth Does Not Always Translate to an Increase in Happiness.

PubMed

Oishi, Shigehiro; Kesebir, Selin

2015-10-01

One of the most puzzling social science findings in the past half century is the Easterlin paradox: Economic growth within a country does not always translate into an increase in happiness. We provide evidence that this paradox can be partly explained by income inequality. In two different data sets covering 34 countries, economic growth was not associated with increases in happiness when it was accompanied by growing income inequality. Earlier instances of the Easterlin paradox (i.e., economic growth not being associated with increasing happiness) can thus be explained by the frequent concurrence of economic growth and growing income inequality. These findings suggest that a more even distribution of growth in national wealth may be a precondition for raising nationwide happiness. © The Author(s) 2015.

Are neighbourhood inequalities in adult health explained by socio-economic and psychosocial determinants in adolescence and the subsequent life course in northern Sweden? A decomposition analysis.

PubMed

Jonsson, Frida; Sebastian, Miguel San; Hammarström, Anne; Gustafsson, Per E

2018-06-07

This study explains neighbourhood deprivation inequalities in adult health for a northern Swedish cohort by examining the contribution of socio-economic and psychosocial determinants from adolescence (age 16), young adulthood (age 21) and midlife (age 42) to the disparity. Self-reported information from 873 participants was drawn from questionnaires, with complementary neighbourhood register data. The concentration index was used to estimate the inequality while decomposition analyses were run to attribute the disparity to its underlying determinants. The results suggest that socio-economic and psychosocial factors in midlife explain a substantial part, but also that the inequality can originate from conditions in adolescence and young adulthood. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Educational inequalities in smoking over the life cycle: an analysis by cohort and gender.

PubMed

Bricard, Damien; Jusot, Florence; Beck, François; Khlat, Myriam; Legleye, Stéphane

2016-01-01

The study investigates the life cycle patterns of educational inequalities in smoking according to gender over three successive generations. Based on retrospective smoking histories collected by the nationwide French Health Barometer survey 2010, we explored educational inequalities in smoking at each age, using the relative index of inequality. Educational inequalities in smoking increase across cohorts for men and women, corresponding to a decline in smoking among the highly educated alongside progression among the lower educated. The analysis also shows a life cycle evolution: for all cohorts and for men and women, inequalities are considerable during adolescence, then start declining from 18 years until the age of peak prevalence (around 25), after which they remain stable throughout the life cycle, even tending to rise for the most recent cohort. This analysis contributes to the description of the "smoking epidemic" and highlights adolescence and late adulthood as life cycle stages with greater inequalities.

Comparison of physical, public and human assets as determinants of socioeconomic inequalities in contraceptive use in Colombia - moving beyond the household wealth index

PubMed Central

2010-01-01

Background Colombia is a lower-middle income country that faces the challenge of addressing health inequalities. This effort includes the task of developing measures of socioeconomic position (SEP) to describe and analyse disparities in health and health related outcomes. This study explores the use of a multidimensional approach to SEP, in which socioeconomic inequalities in contraceptive use are investigated along multiple dimensions of SEP. We tested the hypothesis that provision of Public capital compensated for low levels of Human capital. Methods This study used the 2005 Colombian Demographic and Health Survey (DHS) dataset. The outcome measures were 'current non-use' and 'never use' of contraception. Inequalities in contraceptive behaviour along four measures of SEP were compared: the Household wealth index (HWI), Physical capital (housing, consumer durables), Public capital (publicly provided services) and Human capital (level of education). Principal component analysis was applied to construct the HWI, Physical capital and Public capital measures. Logistic regression models were used to estimate relative indices of inequality (RII) for each measure of SEP with both outcomes. Results Socio-economic inequalities among rural women tended to be larger than those among urban women, for all measures of SEP and for both outcomes. In models mutually adjusted for Physical, Public and Human capital and age, Physical capital identified stronger gradients in contraceptive behaviour in urban and rural areas (Current use of contraception by Physical capital in urban areas RII 2.37 95% CI (1.99-2.83) and rural areas RII 3.70 (2.57-5.33)). The impact of women's level of education on contraceptive behaviour was relatively weak in households with high Public capital compared to households with low Public capital (Current use of contraception in rural areas, interaction p = < 0.001). Reduced educational inequalities attributable to Public capital were partly explained by differences in household wealth but not at all by health insurance cover. Conclusions A multidimensional approach provides a framework for disentangling socioeconomic inequalities in contraceptive behaviour. We provide evidence that material circumstances indexed by Physical capital are important socioeconomic determinants while higher provision of Public capital may compensate for low levels of Human capital with respect to modern contraceptive behaviour. PMID:20380713

The Importance of History in the Racial Inequality and Racial Inequity in Education: New Orleans as a Case Example

ERIC Educational Resources Information Center

Parsons, Eileen Carlton; Turner, Kea

2014-01-01

Racial equality and racial equity in U.S. education has been elusive although decades of education reform have them as goals. Current discourse advocate colorblind and post-racial solutions to racial inequality and racial inequity in education; these solutions implicate presentism, a view that exclusively circumscribes the existence of present-day…

Education policies and health inequalities: evidence from changes in the distribution of Body Mass Index in France, 1981-2003.

PubMed

Etile, Fabrice

2014-03-01

This paper contributes to the debate over the effectiveness of education policies in reducing overall health inequalities as compared to public health actions directed at the less-educated. Recentered Influence Function (RIF) regressions are used to decompose the contribution of education to the changing distribution of Body Mass Index (BMI) in France, between 1981 and 2003, into a composition effect (the shift in population education due to a massive educational expansion), and a structure effect (a changing educational gradient in BMI). Educational expansion has reduced overall BMI inequality by 3.4% for women and 2.3% for men. However, the structure effect on its own has produced a 10.9% increase in overall inequality for women, due to a steeper education gradient starting from the second quartile of the distribution. This structure effect on overall inequality is also large (7.6%) for men, albeit insignificant as it remains concentrated in the last decile. Educational expansion policies can thus reduce overall BMI inequalities; but attention must still be paid to the BMI gradient in education even for policies addressing overall rather than socioeconomic health inequalities. Copyright © 2013 Elsevier B.V. All rights reserved.

Trends in inequalities in premature cancer mortality by educational level in Colombia, 1998–2007

PubMed Central

de Vries, Esther; Arroyave, Ivan; Pardo, Constanza; Wiesner, Carolina; Murillo, Raul; Forman, David; Burdorf, Alex; Avendaño, Mauricio

2015-01-01

Background There is paucity of studies on socioeconomic inequalities in cancer mortality in developing countries. We examined trends in inequalities in cancer mortality by educational attainment in Colombia during a period of epidemiological transition and a rapid expansion of health insurance coverage. Methods Population mortality data (1998–2007) were linked to census data to obtain age-standardised cancer mortality rates by educational attainment at ages 25–64 years for stomach, cervical, prostate, lung, colorectal, breast and other cancers. We used Poisson regression to model mortality by educational attainment and estimated the contribution of specific cancers to the Slope Index of Inequality in cancer mortality. Results We observed large educational inequalities in cancer mortality, particularly for cancer of the cervix (RR primary versus tertiary groups=5.75, contributing 51% of cancer inequalities), stomach (RR=2.56 for males, contributing 49% of total cancer inequalities, and RR=1.98 for females, contributing 14% to total cancer inequalities), and lung (RR=1.64 for males contributing 17% of total cancer inequalities, and 1.32 for females contributing 5% to total cancer inequalities). Total cancer mortality rates declined faster among those with higher education, with the exception of mortality from cervical cancer, which declined more rapidly in the lower educational groups. Conclusion There are large socioeconomic inequalities in preventable cancer mortality in Colombia, which underscore the need for intensifying prevention efforts. Reducing cervical cancer through reducing HPV infection, early detection and improved access to treatment of preneoplasic lesions. Reinforcing anti-tobacco measures may be particularly important to curb inequalities in cancer mortality. PMID:25492898

Social Determinants of Self-Reported Health in Women and Men: Understanding the Role of Gender in Population Health

PubMed Central

Hosseinpoor, Ahmad Reza; Stewart Williams, Jennifer; Amin, Avni; Araujo de Carvalho, Islene; Beard, John; Boerma, Ties; Kowal, Paul; Naidoo, Nirmala; Chatterji, Somnath

2012-01-01

Background Women and men share similar health challenges yet women report poorer health. The study investigates the social determinants of self-reported health in women and men, and male-female differences in health. Methods Data on 103154 men and 125728 women were analysed from 57 countries in the World Health Survey 2002–2004. Item Response Theory was used to construct a composite measure of health. Associations between health and determinants were assessed using multivariate linear regression. Blinder-Oaxaca decomposition partitioned the inequality in health between women and men into an “explained" component that arises because men and women differ in social and economic characteristics, and an “unexplained" component due to the differential effects of these characteristics. Decomposition was repeated for 18 countries in the World Health Organization (WHO) African region and 19 countries in the WHO European region. Results Women's health was significantly lower than men's. Health was associated with education, household economic status, employment, and marital status after controlling for age. In the pooled analysis decomposition showed that 30% of the inequality was “explained", of which almost 75% came from employment, education, marital status. The differential effects of being in paid employment increased the inequality. When countries in Africa and Europe were compared, the “explained" component (31% and 39% respectively) was largely attributed to the social determinants in the African countries and to women's longevity in the European countries. Being in paid employment had a greater positive effect on the health of males in both regions. Conclusions Ways in which age and the social determinants contribute to the poorer health status of women compared with men varies between groups of countries. This study highlights the need for action to address social structures, institutional discrimination and harmful gender norms and roles that differently influence health with ageing. PMID:22514667

Educational inequality in the occurrence of abdominal obesity: Pró-Saúde Study

PubMed Central

Alves, Ronaldo Fernandes Santos; Faerstein, Eduardo

2015-01-01

OBJECTIVE To estimate the degree of educational inequality in the occurrence of abdominal obesity in a population of non-faculty civil servants at university campi. METHODS In this cross-sectional study, we used data from 3,117 subjects of both genders aged 24 to 65-years old, regarding the baseline of Pró-Saúde Study, 1999-2001. Abdominal obesity was defined according to abdominal circumference thresholds of 88 cm for women and 102 cm for men. A multi-dimensional, self-administered questionnaire was used to evaluate education levels and demographic variables. Slope and relative indices of inequality, and Chi-squared test for linear trend were used in the data analysis. All analyses were stratified by genders, and the indices of inequality were standardized by age. RESULTS Abdominal obesity was the most prevalent among women (43.5%; 95%CI 41.2;45.9), as compared to men (24.3%; 95%CI 22.1;26.7), in all educational strata and age ranges. The association between education levels and abdominal obesity was an inverse one among women (p < 0.001); it was not statistically significant among men (p = 0.436). The educational inequality regarding abdominal obesity in the female population, in absolute terms (slope index of inequality), was 24.0% (95%CI 15.5;32.6). In relative terms (relative index of inequality), it was 2.8 (95%CI 1.9;4.1), after the age adjustment. CONCLUSIONS Gender inequality in the prevalence of abdominal obesity increases with older age and lower education. The slope and relative indices of inequality summarize the strictly monotonous trend between education levels and abdominal obesity, and it described educational inequality regarding abdominal obesity among women. Such indices provide relevant quantitative estimates for monitoring abdominal obesity and dealing with health inequalities. PMID:26465669

Educational Inequality in English Primary Education

ERIC Educational Resources Information Center

Richards, Colin

2008-01-01

This paper summarises some English research findings related to educational inequality, particularly in inner urban schools. It documents how differences related to relative poverty are reflected in patterns of educational attainment as revealed by national tests results. It considers and evaluates how the issue of educational inequality in…

Socioeconomic inequalities, health damaging behavior, and self-perceived health in Serbia: a cross-sectional study

PubMed Central

Janković, Janko; Janević, Teresa; von dem Knesebeck, Olaf

2012-01-01

Aim To analyze the association of socioeconomic factors with self-perceived health in Serbia and examine whether this association can be partly explained by health behavior variables. Methods We used data from the 2007 Living Standards Measurement Study for Serbia. A representative sample of 13 831 persons aged ≥20 years was interviewed. The associations between demographic factors (age, sex, marital status, and type of settlement), socioeconomic factors (education, employment status, and household consumption tertiles), and health behavior variables (smoking, alcohol consumption) and self-perceived health were examined using logistic regression analyses. Results A stepwise gradient was found between education and self-perceived health for the total sample, men, and women. Compared to people with high education, people with low education had a 4.5 times higher chance of assessing their health as poor. Unemployed (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.29-2.10), inactive (OR, 2.82; 95% CI, 2.49-3.19), and the most deprived respondents (OR, 1.17; 95% CI, 1.02-1.34) were more likely to report poor self-perceived health than employed persons and the most affluent group. After adjustment for demographic and health behavior variables, the magnitudes of all associations decreased but remained clearly and significantly graded. Conclusions This study revealed inequalities in self-perceived health by socioeconomic position, in particular educational and employment status. The reduction of such inequalities through wisely tailored interventions that benefit people’s health should be a target of a national health policy in Serbia. PMID:22661139

Evolution of Earnings and Rates of Returns to Education in Mexico.

ERIC Educational Resources Information Center

Lopez-Acevedo, Gladys

This paper reviews the factors and mechanisms that have been driving inequality in Mexico and finds that educational inequality accounts for by far the largest share of Mexico's variation in earnings inequality. More specifically, it examines the expansion in earnings inequality with emphasis on the role of education, establishes an analytical…

The policies-inequality feedback and health: the case of globalisation.

PubMed

De Vogli, R; Gimeno, D; Mistry, R

2009-09-01

Major research contributions aimed at explaining the association between economic inequality and health have concentrated on the plausibility of the material deprivation and psychosocial factors pathways. However, little work has analysed the reciprocal associations between public policies and inequality and their effect on health. A conceptual framework was first proposed explaining how the public policies-inequality feedback can influence health outcomes via material deprivation and psychosocial factors. Then, a critical review of the literature was conducted and an analysis of the health effects of the globalisation-inequality feedback as a case study. Different bodies of evidence seem to give support to the hypothesis of a public policies-inequality feedback influencing health-related outcomes. This seems to be particularly true when considering globalisation policies. Since the widespread adoption of the so-called "Washington Consensus", economic inequalities have sharply increased worldwide. The rise in inequality has, in turn, further consolidated the adoption of these policies through an increasing "democratic deficit". The reciprocal effects of globalisation and inequality have produced adverse health outcomes between and within societies through both material deprivation and psychosocial stress. Public policies and economic inequality are inextricably interrelated and can affect health through multiple, indirect, reciprocal pathways.

Ethnic inequalities in dental caries among adults in East London.

PubMed

Delgado-Angulo, Elsa K; Bernabé, Eduardo; Marcenes, Wagner

2016-06-01

This study explored ethnic inequalities in dental caries among adults and assessed the role of socioeconomic position (SEP) in explaining those inequalities. We analysed data on 2013 adults aged 16-65 years, from the East London Oral Health Inequality (ELOHI) Study, which included a random sample of adults and children living in East London in 2009-10. Participants completed a questionnaire and were clinically examined for dental caries at home. Dental caries was measured using the number of decayed, missing and filled teeth or DMFT index. Ethnic inequalities in dental caries were assessed in negative binomial regression models before and after adjustment for demographic (sex and age groups) and SEP measures (education and socioeconomic classification). White Eastern European and White Other had higher DMFT, whereas all Asian (Pakistani, Indian, Bangladeshi and Other) and all Black (African, Caribbean and Other) ethnic groups had lower DMFT than White British. Similar inequalities were found for the number of filled and missing teeth, but there were no differences in the number of decayed teeth between ethnic groups. This study showed considerable disparities in dental caries between and within the major ethnic categories, which were independent of demographics and SEP. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Trends in absolute and relative educational inequalities in four modifiable ischaemic heart disease risk factors: repeated cross-sectional surveys from the Nord-Trøndelag Health Study (HUNT) 1984–2008

PubMed Central

2012-01-01

Background There has been an overall decrease in incident ischaemic heart disease (IHD), but the reduction in IHD risk factors has been greater among those with higher social position. Increased social inequalities in IHD mortality in Scandinavian countries is often referred to as the Scandinavian “public health puzzle”. The objective of this study was to examine trends in absolute and relative educational inequalities in four modifiable ischaemic heart disease risk factors (smoking, diabetes, hypertension and high total cholesterol) over the last three decades among Norwegian middle-aged women and men. Methods Population-based, cross-sectional data from The Nord-Trøndelag Health Study (HUNT): HUNT 1 (1984–1986), HUNT 2 (1995–1997) and HUNT 3 (2006–2008), women and men 40–59 years old. Educational inequalities were assessed using the Slope Index of Inequality (SII) and The Relative Index of Inequality (RII). Results Smoking prevalence increased for all education groups among women and decreased in men. Relative and absolute educational inequalities in smoking widened in both genders, with significantly higher absolute inequalities among women than men in the two last surveys. Diabetes prevalence increased in all groups. Relative inequalities in diabetes were stable, while absolute inequalities increased both among women (p = 0.05) and among men (p = 0.01). Hypertension prevalence decreased in all groups. Relative inequalities in hypertension widened over time in both genders. However, absolute inequalities in hypertension decreased among women (p = 0.05) and were stable among men (p = 0.33). For high total cholesterol relative and absolute inequalities remained stable in both genders. Conclusion Widening absolute educational inequalities in smoking and diabetes over the last three decades gives rise to concern. The mechanisms behind these results are less clear, and future studies are needed to assess if educational inequalities in secondary prevention of IHD are larger compared to educational inequalities in primary prevention of IHD. Continued monitoring of IHD risk factors at the population level is therefore warranted. The results emphasise the need for public health efforts to prevent future burdens of life-style-related diseases and to avoid further widening in socioeconomic inequalities in IHD mortality in Norway, especially among women. PMID:22471945

Socioeconomic inequalities in risk of hospitalization for community-acquired bacteremia: a Danish population-based case-control study.

PubMed

Koch, Kristoffer; Søgaard, Mette; Nørgaard, Mette; Thomsen, Reimar Wernich; Schønheyder, Henrik Carl

2014-05-01

In a Danish population-based case-control study, we examined the association between socioeconomic status (SES) and risk of community-acquired bacteremia, as well as the contribution of chronic diseases and substance abuse to differences in bacteremia risk. Analyses were based on 4,117 patients aged 30-65 years who were hospitalized with first-time community-acquired bacteremia during 2000-2008 and 41,170 population controls matched by sex, age, and region of residence. Individual-level information on SES (education and income), chronic diseases, and substance abuse was retrieved from public and medical registries. Conditional logistic regression was used to compute odds ratios for bacteremia. Persons of low SES had a substantially higher risk of bacteremia than those of high SES (for short duration of education vs. long duration, odds ratio = 2.30 (95% confidence interval: 2.10, 2.52); for low income vs. high income, odds ratio = 2.77 (95% confidence interval: 2.54, 3.02)). A higher prevalence of chronic diseases and substance abuse in low-SES individuals versus high-SES individuals explained 43%-48% of the socioeconomic differences in bacteremia risk. In a country with a universal welfare system, differences in the burden of chronic diseases and substance abuse seem to have major importance in explaining inequalities in bacteremia risk.

Between- and Within-Occupation Inequality: The Case of High-Status Professions*

PubMed Central

Xie, Yu; Killewald, Alexandra; Near, Christopher

2015-01-01

In this chapter, we present analyses of the roles of education and occupation in shaping trends in income inequality among college-educated workers in the U.S., drawing data from two sources: (1) the 1960–2000 U.S. Censuses and (2) the 2006–2008 three-year American Community Survey. We also examine in detail historical trends in between-occupation and within-occupation income inequality for a small set of high-status professionals, with focused attention on the economic wellbeing of scientists. Our research yields four findings. First, education premiums have increased. Second, both between-occupation and within-occupation inequality increased at about the same rates for college graduates, so that the portion of inequality attributable to occupational differences remained constant. Third, scientists have lost ground relative to other similarly educated professionals. Fourth, trends in within-occupation inequality vary by occupation and education, making any sweeping summary on the roles of education and occupation in the overall increase in income inequality difficult. PMID:26977113

Trends in inequalities in premature cancer mortality by educational level in Colombia, 1998-2007.

PubMed

de Vries, Esther; Arroyave, Ivan; Pardo, Constanza; Wiesner, Carolina; Murillo, Raul; Forman, David; Burdorf, Alex; Avendaño, Mauricio

2015-05-01

There is a paucity of studies on socioeconomic inequalities in cancer mortality in developing countries. We examined trends in inequalities in cancer mortality by educational attainment in Colombia during a period of epidemiological transition and rapid expansion of health insurance coverage. Population mortality data (1998-2007) were linked to census data to obtain age-standardised cancer mortality rates by educational attainment at ages 25-64 years for stomach, cervical, prostate, lung, colorectal, breast and other cancers. We used Poisson regression to model mortality by educational attainment and estimated the contribution of specific cancers to the slope index of inequality in cancer mortality. We observed large educational inequalities in cancer mortality, particularly for cancer of the cervix (rate ratio (RR) primary vs tertiary groups=5.75, contributing 51% of cancer inequalities), stomach (RR=2.56 for males, contributing 49% of total cancer inequalities and RR=1.98 for females, contributing 14% to total cancer inequalities) and lung (RR=1.64 for males contributing 17% of total cancer inequalities and 1.32 for females contributing 5% to total cancer inequalities). Total cancer mortality rates declined faster among those with higher education, with the exception of mortality from cervical cancer, which declined more rapidly in the lower educational groups. There are large socioeconomic inequalities in preventable cancer mortality in Colombia, which underscore the need for intensifying prevention efforts. Reduction of cervical cancer can be achieved through reducing human papilloma virus infection, early detection and improved access to treatment of preneoplastic lesions. Reinforcing antitobacco measures may be particularly important to curb inequalities in cancer mortality. 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.

Socioeconomic hierarchy and health gradient in Europe: the role of income inequality and of social origins.

PubMed

Chauvel, Louis; Leist, Anja K

2015-11-14

Health inequalities reflect multidimensional inequality (income, education, and other indicators of socioeconomic position) and vary across countries and welfare regimes. To which extent there is intergenerational transmission of health via parental socioeconomic status has rarely been investigated in comparative perspective. The study sought to explore if different measures of stratification produce the same health gradient and to which extent health gradients of income and of social origins vary with level of living and income inequality. A total of 299,770 observations were available from 18 countries assessed in EU-SILC 2005 and 2011 data, which contain information on social origins. Income inequality (Gini) and level of living were calculated from EU-SILC. Logit rank transformation provided normalized inequalities and distributions of income and social origins up to the extremes of the distribution and was used to investigate net comparable health gradients in detail. Multilevel random-slope models were run to post-estimate best linear unbiased predictors (BLUPs) and related standard deviations of residual intercepts (median health) and slopes (income-health gradients) per country and survey year. Health gradients varied across different measures of stratification, with origins and income producing significant slopes after controls. Income inequality was associated with worse average health, but income inequality and steepness of the health gradient were only marginally associated. Linear health gradients suggest gains in health per rank of income and of origins even at the very extremes of the distribution. Intergenerational transmission of status gains in importance in countries with higher income inequality. Countries differ in the association of income inequality and income-related health gradient, and low income inequality may mask health problems of vulnerable individuals with low status. Not only income inequality, but other country characteristics such as familial orientation play a considerable role in explaining steepness of the health gradient.

Educational inequalities in acute myocardial infarction incidence in Norway: a nationwide cohort study.

PubMed

Igland, Jannicke; Vollset, Stein Emil; Nygård, Ottar K; Sulo, Gerhard; Ebbing, Marta; Tell, Grethe S

2014-01-01

Increasing differences in cardiovascular disease (CVD) mortality across levels of education have been reported in Norway. The aim of the study was to investigate educational inequalities in acute myocardial infarction (AMI) incidence and whether such inequalities have changed during the past decade using a nationwide longitudinal study design. Data on 141 332 incident (first) AMIs in Norway during 2001-2009 were obtained through the Cardiovascular Disease in Norway (CVDNOR) project. Educational inequalities in AMI incidence were assessed in terms of age-standardised incidence rates stratified on educational level, incidence rate ratios (IRR), relative index of inequality (RII) and slope index of inequality (SII). All calculations were conducted in four gender and age strata: Men and women aged 35-69 and 70-94 years. AMI Incidence rates decreased during 2001-2009 for all educational levels except in women aged 35-69 among whom only those with basic education had a significant decrease. In all gender and age groups; those with the highest educational level had the lowest rates. The strongest relative difference was found among women aged 35-69, with IRR (95% CI) for basic versus tertiary education 3.04 (2.85-3.24)) and RII (95% CI) equal to 4.36 (4.03-4.71). The relative differences did not change during 2001-2009 in any of the four gender and age groups, but absolute inequalities measured as SII decreased among the oldest men and women. There are substantial educational inequalities in AMI incidence in Norway, especially for women aged 35-69. Relative inequalities did not change from 2001 to 2009.

Educational Inequality in the United States: Methodology and Historical Estimation of Education Gini Coefficients

ERIC Educational Resources Information Center

Bennett, Daniel L.

2011-01-01

This paper estimates historical measures of equality in the distribution of education in the United States by age group and sex. Using educational attainment data for the population, the EduGini measure indicates that educational inequality in the U.S. declined significantly between 1950 and 2009. Reductions in educational inequality were more…

Inequality as a Way of Life: Education and Social Class in Latin America

ERIC Educational Resources Information Center

Stromquist, Nelly P.

2004-01-01

This article presents a regional analysis of educational inequalities in Latin America, drawing on a variety of sources at the national and cross-national levels. It traces how inequalities in education tend to manifest themselves and which population groups tend to be the most affected. The persistence of inequalities is a curious social…

Should Less Inequality in Education Lead to a More Equal Income Distribution?

ERIC Educational Resources Information Center

Foldvari, Peter; van Leeuwen, Bas

2011-01-01

In this paper, we revisit the question whether inequality in education and human capital is closely related to income inequality. Using the most popular functional forms describing the relationship between, first, output and human capital and, second, education and human capital, we find that the effect of inequality in schooling on income…

Has income-related inequity in health care utilization and expenditures been improved? Evidence from the Korean National Health and Nutrition Examination Survey of 2005 and 2010.

PubMed

Kim, Eunkyoung; Kwon, Soonman; Xu, Ke

2013-09-01

The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

Markers of Psychological Differences and Social and Health Inequalities: Possible Genetic and Phenotypic Overlaps.

PubMed

Mõttus, René; Marioni, Riccardo; Deary, Ian J

2017-02-01

Associations between markers of ostensible psychological characteristics and social and health inequalities are pervasive but difficult to explain. In some cases, there may be causal influence flowing from social and health inequalities to psychological differences, whereas sometimes it may be the other way around. Here, we focus on the possibility that some markers that we often consider as indexing different domains of individual differences may in fact reflect at least partially overlapping genetic and/or phenotypic bases. For example, individual differences in cognitive abilities and educational attainment appear to reflect largely overlapping genetic influences, whereas cognitive abilities and health literacy may be almost identical phenomena at the phenotypic, never mind genetic, level. We make the case for employing molecular genetic data and quantitative genetic techniques to better understand the associations of psychological individual differences with social and health inequalities. We illustrate these arguments by using published findings from the Lothian Birth Cohort and the Generation Scotland studies. We also present novel findings pertaining to longitudinal stability and change in older age personality traits and some correlates of the change, molecular genetic data-based heritability estimates of Neuroticism and Extraversion, and the genetic correlations of these personality traits with markers of social and health inequalities. © 2015 The Authors. Journal of Personality published by Wiley Periodicals, Inc.

What lies behind gender inequalities in HIV/AIDS in sub-Saharan African countries: evidence from Kenya, Lesotho and Tanzania

PubMed Central

Sia, Drissa; Onadja, Yentéma; Nandi, Arijit; Foro, Anne; Brewer, Timothy

2014-01-01

Within sub-Saharan Africa, women are disproportionately at risk for acquiring and having human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). It is important to clarify whether gender inequalities in HIV prevalence in this region are explained by differences in the distributions of HIV risk factors, differences in the effects of these risk factors or some combination of both. We used an extension of the Blinder–Oaxaca decomposition approach to explain gender inequalities in HIV/AIDS in Kenya, Lesotho and Tanzania using data from the demographic and health and AIDS indicator surveys. After adjusting for covariates using Poisson regression models, female gender was associated with a higher prevalence of HIV/AIDS in Kenya [prevalence ratio (PR) = 1.73, 95% confidence interval (CI) = 1.33, 2.23 in 2003] and Lesotho (PR = 1.39, 95% CI = 1.20, 1.62 in 2004/05), but not in Tanzania. Decomposition analyses demonstrated two distinct patterns over time. In Tanzania, the gender inequality in HIV/AIDS was explained by differences in the distributions of HIV risk factors between men and women. In contrast, in Kenya and Lesotho, this inequality was partly explained by differences in the effects across men and women of measured HIV/AIDS risk factors, including socio-demographic characteristics (age and marital status) and sexual behaviours (age at first sex); these results imply that gender inequalities in HIV/AIDS would persist in Kenya and Lesotho even if men and women had similar distributions of HIV risk factors. The production of gender inequalities may vary across countries, with inequalities attributable to the unequal distribution of risk factors among men and women in some countries and the differential effect of these factors between groups in others. These different patterns have important implications for policies to reduce gender inequalities in HIV/AIDS. PMID:24345343

Educational inequalities in subjective health in Germany from 1994 to 2014: a trend analysis using the German Socio-Economic Panel study (GSOEP).

PubMed

Moor, Irene; Günther, Sebastian; Knöchelmann, Anja; Hoebel, Jens; Pförtner, Timo-Kolja; Lampert, Thomas; Richter, Matthias

2018-06-08

As trend studies have shown, health inequalities by income and occupation have widened or remained stable. However, research on time trends in educational inequalities in health in Germany is scarce. The aim of this study is to analyse how educational inequalities in health evolved over a period of 21 years in the middle-aged population in Germany, and whether the trends differ by gender. Data were obtained from the German Socio-Economic Panel covering the period from 1994 to 2014. In total, n=16 339 participants (106 221 person years) aged 30-49 years were included in the study sample. Educational level was measured based on the 'Comparative Analysis of Social Mobility in Industrial Nations' (CASMIN) classification. Health outcomes were self-rated health (SRH) as well as (mental and physical) health-related quality of life (HRQOL, SF-12v2). Absolute Index of Inequality (Slope Index of Inequality (SII)) and Relative Index of Inequality (RII) were calculated using linear and logarithmic regression analyses with robust SEs. Significant educational inequalities in SRH and physical HRQOL were found for almost every survey year from 1994 to 2014. Relative inequalities in SRH ranged from 1.50 to 2.10 in men and 1.25 to 1.87 in women (RII). Regarding physical HRQOL, the lowest educational group yielded 4.5 to 6.6 points (men) and 3.3 to 6.1 points (women) lower scores (SII). Although educational level increased over time, absolute and relative health inequalities remained largely stable over the last 21 years. For mental HRQOL, only few educational inequalities were found. This study found persistent educational inequalities in SRH and physical HRQOL among adults in Germany from 1994 to 2014. Our findings highlight the need to intensify efforts in social and health policies to tackle these persistent inequalities. © 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.

Occupation and educational inequalities in laryngeal cancer: the use of a job index

PubMed Central

2013-01-01

Background Previous studies tried to assess the association between socioeconomic status and laryngeal cancer. Alcohol and tobacco consumption explain already a large part of the social inequalities. Occupational exposures might explain a part of the remaining but the components and pathways of the socioeconomic contribution have yet to be fully disentangled. The aim of this study was to evaluate the role of occupation using different occupational indices, differentiating between physical, psycho-social and toxic exposures and trying to summarize the occupational burden into one variable. Methods A population-based case–control study conducted in Germany in 1998–2000 included 208 male cases and 702 controls. Information on occupational history, smoking, alcohol consumption and education was collected with face-to-face interviews. A recently developed job-classification index was used to account for the occupational burden. A sub-index focussed on jobs involving potentially carcinogenic agents (CAI) for the upper aero digestive tract. Results When adjusted for smoking and alcohol consumption, higher odds ratios (ORs) were found for lower education. This OR decreased after further adjustment using the physical and psycho-social job indices (OR = 3.2, 95%-CI: 1.5-6.8), similar to the OR using the sub-index CAI (OR = 3.0, 95%-CI: 1.4-6.5). Conclusions The use of an easily applicable control variable, simply constructed on standard occupational job classifications, provides the possibility to differentiate between educational and occupational contributions. Such an index might indirectly reflect the effect of carcinogenic agents, which are not collected in many studies. PMID:24246148

Educational Systems and Rising Inequality: Eastern Germany after Unification

ERIC Educational Resources Information Center

von Below, Susanne; Powell, Justin J. W.; Roberts, Lance W.

2013-01-01

Educational systems considerably influence educational opportunities and the resulting social inequalities. Contrasting institutional regulations of both structures and contents, the authors present a typology of educational system types in Germany to analyze their effects on social inequality in eastern Germany after unification. After 1990, the…

Trends in mental health inequalities in England during a period of recession, austerity and welfare reform 2004 to 2013.

PubMed

Barr, Ben; Kinderman, Peter; Whitehead, Margaret

2015-12-01

Several indicators of population mental health in the UK have deteriorated since the financial crisis, during a period when a number of welfare reforms and austerity measures have been implemented. We do not know which groups have been most affected by these trends or the extent to which recent economic trends or recent policies have contributed to them. We use data from the Quarterly Labour Force Survey to investigate trends in self reported mental health problems by socioeconomic group and employment status in England between 2004 and 2013. We then use panel regression models to investigate the association between local trends in mental health problems and local trends in unemployment and wages to investigate the extent to which these explain increases in mental health problems during this time. We found that the trend in the prevalence of people reporting mental health problems increased significantly more between 2009 and 2013 compared to the previous trends. This increase was greatest amongst people with low levels of education and inequalities widened. The gap in prevalence between low and high educated groups widened by 1.29 percentage points for women (95% CI: 0.50 to 2.08) and 1.36 percentage points for men (95% CI: 0.31 to 2.42) between 2009 and 2013. Trends in unemployment and wages only partly explained these recent increases in mental health problems. The trend in reported mental health problems across England broadly mirrored the pattern of increases in suicides and antidepressant prescribing. Welfare policies and austerity measures implemented since 2010 may have contributed to recent increases in mental health problems and widening inequalities. This has led to rising numbers of people with low levels of education out of work with mental health problems. These trends are likely to increase social exclusion as well as demand for and reliance on social welfare systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

Educational inequalities in tuberculosis mortality in sixteen European populations

PubMed Central

Álvarez, J. L.; Kunst, A. E.; Leinsalu, M.; Bopp, M.; Strand, B. H.; Menvielle, Gwenn; Lundberg, O.; Martikainen, P.; Deboosere, P.; Kalediene, R.; Artnik, B.; Mackenbach, J. P.; Richardus, J. H.

2011-01-01

Objective We aim to describe the magnitude of socioeconomic inequalities in tuberculosis (TB) mortality by level of education in male, female, urban, and rural populations in several European countries. Design Data were obtained from the Eurothine project covering 16 populations between 1990 and 2003. Age- and sex-standardized mortality rates, the Relative Index of Inequality, and the slope index of inequality were used to assess educational inequalities. Results The number of TB deaths reported was 8530, with a death rate of 3 per 100 000 per year, of which 73% were males. Educational inequalities in TB mortality were present in all European populations. Inequalities in TB mortality were larger than in total mortality. Relative and absolute inequalities were large in Eastern Europe, and Baltic countries but relatively small in Southern countries and in Norway, Finland, and Sweden. Mortality inequalities were observed among both men and women, and in both rural and urban populations. Conclusions Socioeconomic inequalities in TB mortality exist in all European countries. Firm political commitment is required to reduce inequalities in the social determinants of TB incidence. Targeted public health measures are called for to improve vulnerable groups’ access to treatment and thereby reduce TB mortality. PMID:22008757

Why poverty remains high: the role of income growth, economic inequality, and changes in family structure, 1949-1999.

PubMed

Iceland, John

2003-08-01

After dramatic declines in poverty from 1950 to the early 1970s in the United States, progress stalled. This article examines the association between trends in poverty and income growth, economic inequality, and changes in family structure using three measures of poverty: an absolute measure, a relative measure, and a quasi-relative one. I found that income growth explains most of the trend in absolute poverty, while inequality generally plays the most significant role in explaining trends in relative poverty. Rising inequality in the 1970s and 1980s was especially important in explaining increases in poverty among Hispanics, whereas changes in family structure played a significant role for children and African Americans through 1990. Notably, changes in family structure no longer had a significant association with trends in poverty for any group in the 1990s.

Education Expansion, Educational Inequality, and Income Inequality: Evidence from Taiwan, 1976-2003

ERIC Educational Resources Information Center

Lin, Chun-Hung A.

2007-01-01

The expansion of higher education in Taiwan starting from the late 1980s has successfully raised the average level of education. Using the concept of the education Gini, we find that the educational inequality declined as average schooling rose during the period of 1976-2003. The impacts of a rising average schooling and a declining educational…

Social Inequality in Access to Higher Education: Grade Inflation in Private Schools and the Ineffectiveness of Compensatory Education

ERIC Educational Resources Information Center

Neves, Tiago; Ferraz, Hélder; Nata, Gil

2016-01-01

Access to higher education is affected by inequalities worldwide. Here we present a longitudinal study based on large databases of scores in upper secondary education and access to higher education in Portugal. Our findings show how access to higher education builds on and reinforces social inequalities: (1) private, fee-paying secondary schools…

The Economics of Inequality in Education. Studies in Economic Development and Planning, No. 44.

ERIC Educational Resources Information Center

Tilak, Jandhyala B. G.

The purpose of this study is to examine the various economic facets of inequality in education in India. The specific focus is on inter-group inequalities, such as inequality between males and females and between backward and advanced castes. It is hypothesized that returns to education accrue differently to different groups of population and…

Institutional Educational Technology Policy and Strategy Documents: An Inequality Gaze

ERIC Educational Resources Information Center

Czerniewicz, Laura; Rother, Kyle

2018-01-01

Issues of inequality in higher education have received considerable attention in recent decades, but the intersection of inequality and educational technology at an institutional level has received little attention. This study aims to provide a perspective on institutional educational technology policy informed by current understandings of…

Diversity, Inequality, and a Post-Structural Politics for Education

ERIC Educational Resources Information Center

Youdell, Deborah

2006-01-01

This paper considers the contribution to understanding educational inequalities offered by post-structural theories of power and the subject. The paper locates this consideration in the context of the ongoing endeavour in education studies to make sense of, and identify ways of interrupting, abiding educational exclusions and inequalities. The…

Modifiable behaviors help to explain the inequalities in perceived health associated with deprivation and social class: evidence from a national sample.

PubMed

Nevill, Alan; Donnelly, Paul; Shibli, Simon; Foster, Charlie; Murphy, Marie

2014-02-01

The association between health and deprivation is of serious concern to many health promotion agencies. The purpose of the current study was to assess whether modifiable behaviors of physical activity (PA), sports participation, diet, smoking and body mass index (BMI) can help to explain these inequalities in a sample of 4653 respondents from Northern Ireland. The study is based on a cross-sectional survey of Northern Irish adults. Responses to a self-rated health question were dichotomized and binary logistic regression was used to identify the health inequalities between areas of high, middle or low deprivation. These differences were further adjusted for other sociodemographic factors and subsequently for various modifiable behaviors of PA, sports participation, diet, smoking, and BMI. Respondents from high and middle areas of deprivation are more likely to report poorer health. As soon as sociodemographic factors and other modifiable behaviors were included, these inequalities either disappeared or were greatly reduced. Many inequalities in health in NI can be explained by the respondents' sociodemographic characteristics that can be further explained by introducing information about respondents who meet the recommended PA guidelines, play sport, eat 5 portions of fruit and vegetables, and maintain an optimal BMI.

Educational Inequalities in Acute Myocardial Infarction Incidence in Norway: A Nationwide Cohort Study

PubMed Central

Igland, Jannicke; Vollset, Stein Emil; Nygård, Ottar K.; Sulo, Gerhard; Ebbing, Marta; Tell, Grethe S.

2014-01-01

Background Increasing differences in cardiovascular disease (CVD) mortality across levels of education have been reported in Norway. The aim of the study was to investigate educational inequalities in acute myocardial infarction (AMI) incidence and whether such inequalities have changed during the past decade using a nationwide longitudinal study design. Methods Data on 141 332 incident (first) AMIs in Norway during 2001–2009 were obtained through the Cardiovascular Disease in Norway (CVDNOR) project. Educational inequalities in AMI incidence were assessed in terms of age-standardised incidence rates stratified on educational level, incidence rate ratios (IRR), relative index of inequality (RII) and slope index of inequality (SII). All calculations were conducted in four gender and age strata: Men and women aged 35–69 and 70–94 years. Results AMI Incidence rates decreased during 2001–2009 for all educational levels except in women aged 35–69 among whom only those with basic education had a significant decrease. In all gender and age groups; those with the highest educational level had the lowest rates. The strongest relative difference was found among women aged 35–69, with IRR (95% CI) for basic versus tertiary education 3.04 (2.85–3.24)) and RII (95% CI) equal to 4.36 (4.03–4.71). The relative differences did not change during 2001–2009 in any of the four gender and age groups, but absolute inequalities measured as SII decreased among the oldest men and women. Conclusions There are substantial educational inequalities in AMI incidence in Norway, especially for women aged 35–69. Relative inequalities did not change from 2001 to 2009. PMID:25188248

Income-related inequality in health and health care utilization in Chile, 2000-2009.

PubMed

Vásquez, Felipe; Paraje, Guillermo; Estay, Manuel

2013-02-01

To measure and explain income-related inequalities in health and health care utilization in the period 2000 - 2009 in Chile, while assessing variations within the country and determinants of inequalities. Data from the National Socioeconomic Characterization Survey for 2000, 2003, and 2009 were used to measure inequality in health and health care utilization. Income-related inequality in health care utilization was assessed with standardized concentration indices for the probability and total number of visits to specialized care, generalized care, emergency care, dental care, mental health care, and hospital care. Self-assessed health status and physical limitations were used as proxies for health care need. Standardization was performed with demographic and need variables. The decomposition method was applied to estimate the contribution of each factor used to calculate the concentration index, including ethnicity, employment status, health insurance, and region of residence. In Chile, people in lower-income quintiles report worse health status and more physical limitations than people in higher quintiles. In terms of health service utilization, pro-rich inequities were found for specialized and dental visits with a slight pro-rich utilization for general practitioners and all physician visits. All pro-rich inequities have decreased over time. Emergency room visits and hospitalizations are concentrated among lower-income quintiles and have increased over time. Higher education and private health insurance contribute to a pro-rich inequity in dentist, general practitioner, specialized, and all physician visits. Income contributes to a pro-rich inequity in specialized and dentist visits, whereas urban residence and economic activity contribute to a pro-poor inequity in emergency room visits. The pattern of health care utilization in Chile is consistent with policies implemented in the country and in the intended direction. The significant income inequality in the use of specialized and dental services, which favor the rich, deserves policy makers' attention and further investigation related to the quality of these services.

How do trends in mortality inequalities by deprivation and education in Scotland and England & Wales compare? A repeat cross-sectional study.

PubMed

McCartney, Gerry; Popham, Frank; Katikireddi, Srinivasa Vittal; Walsh, David; Schofield, Lauren

2017-07-21

To compare the trends in mortality inequalities by educational attainment with trends using area deprivation. Scotland and England & Wales (E&W). All people resident in Scotland and E&W between 1981 and 2011 aged 35-79 years. Absolute inequalities (measured using the Slope Index of Inequality (SII)) and relative inequalities (measured using the Relative Index of Inequality (RII)) in all-cause mortality. Relative inequalities in mortality by area deprivation have consistently increased for men and women in Scotland and E&W between 1981-1983 and 2010-2012. Absolute inequalities increased for men and women in Scotland, and for women in E&W, between 1981-1983 and 2000-2002 before subsequently falling. For men in E&W, absolute inequalities were more stable until 2000-2002 before a subsequent decline. Both absolute and relative inequalities were consistently higher in men and in Scotland. These trends contrast markedly with the reported declines in mortality inequalities by educational attainment and apparent improvement of Scotland's inequalities with those in E&W. Trends in health inequalities differ when assessed using different measures of socioeconomic status, reflecting either genuinely variable trends in relation to different aspects of social stratification or varying error or bias. There are particular issues with the educational attainment data in Great Britain prior to 2001 that make these education-based estimates less certain. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Irritable bowel syndrome is concentrated in people with higher educations in Iran: an inequality analysis.

PubMed

Mansouri, Asieh; Rarani, Mostafa Amini; Fallahi, Mosayeb; Alvandi, Iman

2017-01-01

Like any other health-related disorder, irritable bowel syndrome (IBS) has a differential distribution with respect to socioeconomic factors. This study aimed to estimate and decompose educational inequalities in the prevalence of IBS. Sampling was performed using a multi-stage random cluster sampling approach. The data of 1,850 residents of Kish Island aged 15 years or older were included, and the determinants of IBS were identified using a generalized estimating equation regression model. The concentration index of educational inequality in cases of IBS was estimated and decomposed as the specific inequality index. The prevalence of IBS in this study was 21.57% (95% confidence interval [CI], 19.69 to 23.44%). The concentration index of IBS was 0.20 (95% CI, 0.14 to 0.26). A multivariable regression model revealed that age, sex, level of education, marital status, anxiety, and poor general health were significant determinants of IBS. In the decomposition analysis, level of education (89.91%), age (-11.99%), and marital status (9.11%) were the three main contributors to IBS inequality. Anxiety and poor general health were the next two contributors to IBS inequality, and were responsible for more than 12% of the total observed inequality. The main contributors of IBS inequality were education level, age, and marital status. Given the high percentage of anxious individuals among highly educated, young, single, and divorced people, we can conclude that all contributors to IBS inequality may be partially influenced by psychological factors. Therefore, programs that promote the development of mental health to alleviate the abovementioned inequality in this population are highly warranted.

Diverging trends in educational inequalities in cancer mortality between men and women in the 2000s in France

PubMed Central

2013-01-01

Background Socioeconomic inequalities in cancer mortality have been observed in different European countries and the US until the end of the 1990s, with changes over time in the magnitude of these inequalities and contrasted situations between countries. The aim of this study is to estimate relative and absolute educational differences in cancer mortality in France between 1999 and 2007, and to compare these inequalities with those reported during the 1990s. Methods Data from a representative sample including 1% of the French population were analysed. Educational differences among people aged 30–74 were quantified with hazard ratios and relative indices of inequality (RII) computed using Cox regression models as well as mortality rate difference and population attributable fraction. Results In the period 1999–2007, large relative inequalities were found among men for total cancer and smoking and/or alcohol related cancers mortality (lung, head and neck, oesophagus). Among women, educational differences were reported for total cancer, head and neck and uterus cancer mortality. No association was found between education and breast cancer mortality. Slight educational differences in colorectal cancer mortality were observed in men and women. For most frequent cancers, no change was observed in the magnitude of relative inequalities in mortality between the 1990s and the 2000s, although the RII for lung cancer increased both in men and women. Among women, a large increase in absolute inequalities in mortality was observed for all cancers combined, lung, head and neck and colorectal cancer. In contrast, among men, absolute inequalities in mortality decreased for all smoking and/or alcohol related cancers. Conclusion Although social inequalities in cancer mortality are still high among men, an encouraging trend is observed. Among women though, the situation regarding social inequalities is less favourable, mainly due to a health improvement limited to higher educated women. These inequalities may be expected to further increase in future years. PMID:24015917

Diverging trends in educational inequalities in cancer mortality between men and women in the 2000s in France.

PubMed

Menvielle, Gwenn; Rey, Grégoire; Jougla, Eric; Luce, Danièle

2013-09-10

Socioeconomic inequalities in cancer mortality have been observed in different European countries and the US until the end of the 1990s, with changes over time in the magnitude of these inequalities and contrasted situations between countries. The aim of this study is to estimate relative and absolute educational differences in cancer mortality in France between 1999 and 2007, and to compare these inequalities with those reported during the 1990s. Data from a representative sample including 1% of the French population were analysed. Educational differences among people aged 30-74 were quantified with hazard ratios and relative indices of inequality (RII) computed using Cox regression models as well as mortality rate difference and population attributable fraction. In the period 1999-2007, large relative inequalities were found among men for total cancer and smoking and/or alcohol related cancers mortality (lung, head and neck, oesophagus). Among women, educational differences were reported for total cancer, head and neck and uterus cancer mortality. No association was found between education and breast cancer mortality. Slight educational differences in colorectal cancer mortality were observed in men and women. For most frequent cancers, no change was observed in the magnitude of relative inequalities in mortality between the 1990s and the 2000s, although the RII for lung cancer increased both in men and women. Among women, a large increase in absolute inequalities in mortality was observed for all cancers combined, lung, head and neck and colorectal cancer. In contrast, among men, absolute inequalities in mortality decreased for all smoking and/or alcohol related cancers. Although social inequalities in cancer mortality are still high among men, an encouraging trend is observed. Among women though, the situation regarding social inequalities is less favourable, mainly due to a health improvement limited to higher educated women. These inequalities may be expected to further increase in future years.

Trends in educational inequalities in cause specific mortality in Norway from 1960 to 2010: a turning point for educational inequalities in cause specific mortality of Norwegian men after the millennium?

PubMed

Strand, Bjørn Heine; Steingrímsdóttir, Ólöf Anna; Grøholt, Else-Karin; Ariansen, Inger; Graff-Iversen, Sidsel; Næss, Øyvind

2014-11-24

Educational inequalities in total mortality in Norway have widened during 1960-2000. We wanted to investigate if inequalities have continued to increase in the post millennium decade, and which causes of deaths were the main drivers. All deaths (total and cause specific) in the adult Norwegian population aged 45-74 years over five decades, until 2010 were included; in all 708,449 deaths and over 62 million person years. Two indices of inequalities were used to measure inequality and changes in inequalities over time, on the relative scale (Relative Index of Inequality, RII) and on the absolute scale (Slope Index of Inequality, SII). Relative inequalities in total mortality increased over the five decades in both genders. Among men absolute inequalities stabilized during 2000-2010, after steady, significant increases each decade back to the 1960s, while in women, absolute inequalities continued to increase significantly during the last decade. The stabilization in absolute inequalities among men in the last decade was mostly due to a fall in inequalities in cardiovascular disease (CVD) mortality and lung cancer and respiratory disease mortality. Still, in this last decade, the absolute inequalities in cause-specific mortality among men were mostly due to cardiovascular diseases (CVD) (34% of total mortality inequality), lung cancer and respiratory diseases (21%). Among women the absolute inequalities in mortality were mostly due to lung cancer and chronic lower respiratory tract diseases (30%) and CVD (27%). In men, absolute inequalities in mortality have stopped increasing, seemingly due to reduction in inequalities in CVD mortality. Absolute inequality in mortality continues to widen among women, mostly due to death from lung cancer and chronic lung disease. Relative educational inequalities in mortality are still on the rise for Norwegian men and women.

Educational inequalities in mortality over four decades in Norway: prospective study of middle aged men and women followed for cause specific mortality, 1960-2000.

PubMed

Strand, Bjørn Heine; Grøholt, Else-Karin; Steingrímsdóttir, Olöf Anna; Blakely, Tony; Graff-Iversen, Sidsel; Naess, Øyvind

2010-02-23

To determine the extent to which educational inequalities in relation to mortality widened in Norway during 1960-2000 and which causes of death were the main drivers of this disparity. Nationally representative prospective study. Four cohorts of the Norwegian population aged 45-64 years in 1960, 1970, 1980, and 1990 and followed up for mortality over 10 years. 359 547 deaths and 32 904 589 person years. All cause mortality and deaths due to cancer of lung, trachea, or bronchus; other cancer; cardiovascular diseases; suicide; external causes; chronic lower respiratory tract diseases; or other causes. Absolute and relative indices of inequality were used to present differences in mortality by educational level (basic, secondary, and tertiary). Mortality fell from the 1960s to the 1990s in all educational groups. At the same time the proportion of adults in the basic education group, with the highest mortality, decreased substantially. As mortality dropped more among those with the highest level of education, inequalities widened. Absolute inequalities in mortality denoting deaths among the basic education groups minus deaths among the high education groups doubled in men and increased by a third in women. This is equivalent to an increase in the slope index of inequality of 105% in men and 32% in women. Inequalities on a relative scale widened more, from 1.33 to 2.24 among men (P=0.01) and from 1.52 to 2.19 among women (P=0.05). Among men, absolute inequalities mainly increased as a result of cardiovascular diseases, lung cancer, and chronic lower respiratory tract diseases. Among women this was mainly due to lung cancer and chronic lower respiratory tract diseases. Unlike the situation in men, absolute inequalities in deaths due to cardiovascular causes narrowed among women. Chronic lower respiratory tract diseases contributed more to the disparities in inequalities among women than among men. All educational groups showed a decline in mortality. Nevertheless, and despite the fact that the Norwegian welfare model is based on an egalitarian ideology, educational inequalities in mortality among middle aged people in Norway are substantial and increased during 1960-2000.

The mediating role of social capital in the association between neighbourhood income inequality and body mass index.

PubMed

Mackenbach, Joreintje D; Lakerveld, Jeroen; van Oostveen, Yavanna; Compernolle, Sofie; De Bourdeaudhuij, Ilse; Bárdos, Helga; Rutter, Harry; Glonti, Ketevan; Oppert, Jean-Michel; Charreire, Helene; Brug, Johannes; Nijpels, Giel

2017-04-01

Neighbourhood income inequality may contribute to differences in body weight. We explored whether neighbourhood social capital mediated the association of neighbourhood income inequality with individual body mass index (BMI). A total of 4126 adult participants from 48 neighbourhoods in France, Hungary, the Netherlands and the UK provided information on their levels of income, perceptions of neighbourhood social capital and BMI. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. Neighbourhood income inequality was defined as the ratio of the amount of income earned by the top 20% and the bottom 20% in a given neighbourhood. Two single mediation analyses-using multilevel linear regression analyses-with neighbourhood social networks and neighbourhood social cohesion as possible mediators-were conducted using MacKinnon's product-of-coefficients method, adjusted for age, gender, education and absolute household income. Higher neighbourhood income inequality was associated with elevated levels of BMI and lower levels of neighbourhood social networks and neighbourhood social cohesion. High levels of neighbourhood social networks were associated with lower BMI. Results stratified by country demonstrate that social networks fully explained the association between income inequality and BMI in France and the Netherlands. Social cohesion was only a significant mediating variable for Dutch participants. The results suggest that in some European urban regions, neighbourhood social capital plays a large role in the association between neighbourhood income inequality and individual BMI. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Social inequalities in obesity and overweight in 11 OECD countries.

PubMed

Devaux, Marion; Sassi, Franco

2013-06-01

Evidence of inequalities in obesity and overweight is available mostly from national studies. This article provides a broad international comparison of inequalities by education level and socio-economic status, in men and women and over time. Data from national health surveys of 11 OECD countries were used. The size of inequalities was assessed on the basis of absolute and relative inequality indexes. A regression-analysis approach was used to assess differences between social groups in trends over time. Of the countries examined, USA and England had the highest rates of obesity and overweight. Large social inequalities were consistently detected in all countries, especially in women. Absolute inequalities were largest in Hungary and Spain with a difference of 11.6 and 10% in obesity rates in men, and 18.3 and 18.9% in women, respectively, across the education spectrum. Relative inequalities were largest in France and Sweden with poorly educated men 3.2 and 2.8 times as likely to be obese as men with the highest education (18 and 17 times for women in Spain and Korea, respectively). Pro-poor inequalities in overweight were observed for men in USA, Canada, Korea, Hungary, Australia and England. Inequalities remained virtually stable during the last 15 years, with only small variations in England, Korea, Italy and France. Large and persistent social inequalities in obesity and overweight by education level and socio-economic status exist in OECD countries. These are consistently larger in women than in men.

Does the psychosocial quality of unpaid family work contribute to educational disparities in mental health among employed partnered mothers?

PubMed

Janzen, Bonnie; Hellsten, Laurie-Ann M

2018-04-24

The contribution of unpaid family work quality to understanding social inequalities in women's mental health has been understudied and further limited by a scarcity of psychometrically sound instruments available to measure family work. Therefore, using a multi-item scale of family work quality with evidence of validity and reliability, the overall aim of the present study was to determine whether psychosocial qualities of unpaid family work contribute to educational inequities in women's mental health. Study participants in this cross-sectional study were 512 employed partnered mothers living in a Canadian province and recruited from an online research panel. The dependent variable was psychological distress. In addition to a 28-item measure assessing five dimensions of unpaid family work quality, independent variables included material deprivation, job decision latitude, job demands and several measures of the work-family interface. Multiple linear regression was the primary analysis. Compared to women with high school or less, university educated women reported lower psychological distress [b = - 2.23 (SE = 0.50) p = 0.001]. The introduction of material deprivation into the model resulted in the largest reduction to the education disparity (51%), followed by equity in responsibility for unpaid family work (25%), family-to-work facilitation (22%), and decision latitude in paid work (21%). When entered simultaneously into the final model, the association between education and psychological distress was reduced by 70% and became statistically non-significant [b = - 0.68 (SE = 0.47) p = 0.10]. In addition to the more established mechanisms of material conditions and decision latitude to explain mental health disparities, inequity in responsibility for unpaid family work may also play a role.

The Impact of Tobacco Control Policies on Smoking Among Socioeconomic Groups in Nine European Countries, 1990-2007.

PubMed

Hu, Yannan; van Lenthe, Frank J; Platt, Stephen; Bosdriesz, Jizzo R; Lahelma, Eero; Menvielle, Gwenn; Regidor, Enrique; Santana, Paula; de Gelder, Rianne; Mackenbach, Johan P

2017-11-07

It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries during the past two decades. This paper aims to investigate the impact of price and non-price related population-wide tobacco control policies on smoking by socioeconomic group in nine European countries between 1990 and 2007. Individual-level education, occupation and smoking status were obtained from nationally representative surveys. Country-level price-related tobacco control policies were measured by the relative price of cheapest cigarettes and of cigarettes in the most popular price category. Country-level non-price policies were measured by a summary score covering four policy domains: smoking bans or restrictions in public places and workplaces, bans on advertising and promotion, health warning labels, and cessation services. The associations between policies and smoking were explored using logistic regressions, stratified by education and occupation, and adjusted for age, Gross Domestic Product, period and country fixed effects. The price of popular cigarettes and non-price policies were negatively associated with smoking among men. The price of the cheapest cigarettes was negatively associated with smoking among women. While these favorable effects were generally in the same direction for all socioeconomic groups, they were larger and statistically significant in lower socioeconomic groups only. Tobacco control policies as implemented in nine European countries, have probably helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. Policies with larger effects on lower socioeconomic groups are needed to reverse this trend. Socioeconomic inequalities in smoking widened between the 1990s and the 2000s in Europe. During the same period, there were intensified tobacco control policies in many European countries. It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries. This study shows that tobacco control policies as implemented in the available European countries have helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. © 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.

Irritable bowel syndrome is concentrated in people with higher educations in Iran: an inequality analysis

PubMed Central

2017-01-01

OBJECTIVES Like any other health-related disorder, irritable bowel syndrome (IBS) has a differential distribution with respect to socioeconomic factors. This study aimed to estimate and decompose educational inequalities in the prevalence of IBS. METHODS Sampling was performed using a multi-stage random cluster sampling approach. The data of 1,850 residents of Kish Island aged 15 years or older were included, and the determinants of IBS were identified using a generalized estimating equation regression model. The concentration index of educational inequality in cases of IBS was estimated and decomposed as the specific inequality index. RESULTS The prevalence of IBS in this study was 21.57% (95% confidence interval [CI], 19.69 to 23.44%). The concentration index of IBS was 0.20 (95% CI, 0.14 to 0.26). A multivariable regression model revealed that age, sex, level of education, marital status, anxiety, and poor general health were significant determinants of IBS. In the decomposition analysis, level of education (89.91%), age (−11.99%), and marital status (9.11%) were the three main contributors to IBS inequality. Anxiety and poor general health were the next two contributors to IBS inequality, and were responsible for more than 12% of the total observed inequality. CONCLUSIONS The main contributors of IBS inequality were education level, age, and marital status. Given the high percentage of anxious individuals among highly educated, young, single, and divorced people, we can conclude that all contributors to IBS inequality may be partially influenced by psychological factors. Therefore, programs that promote the development of mental health to alleviate the abovementioned inequality in this population are highly warranted. PMID:28171714

Four Decades of Obesity Trends among Non-Hispanic Whites and Blacks in the United States: Analyzing the Influences of Educational Inequalities in Obesity and Population Improvements in Education.

PubMed

Yu, Yan

2016-01-01

Both obesity (body mass index ≥ 30) and educational attainment have increased dramatically in the United States since the 1970s. This study analyzed the influences of educational inequalities in obesity and population improvements in education on national obesity trends between 1970 and 2010. For non-Hispanic white and black males and females aged 25-74 years, educational differences in the probability of being obese were estimated from the 1971-2012 National Health and Nutrition Examination Surveys, and population distributions of age and educational groups, from the 1970 Census and 2010 American Community Survey. In the total population, obesity increased from 15.7% to 38.8%, and there were increases in the greater obese probabilities of non-college graduates relative to four-year college graduates. The increase in obesity would have been lower by 10% (2.2 percentage points) if educational inequalities in obesity had stayed at their 1970 values and lower by one third (7.9 points) if obesity inequalities had been eliminated. Obesity inequalities were larger for females than males and for whites than blacks, and obesity did not differ by education among black males. As a result, the impact of obesity inequalities on the obesity trend was largest among white females (a 47% reduction in the obesity increase if obesity inequalities had been eliminated), and virtually zero among black males. On the other hand, without educational improvements, the obesity increase would have been 9% more in the total population, 23% more among white females and not different in the other three subpopulations. Results indicate that obesity inequalities made sizable contributions to the obesity trends, and the obesity reductions associated with educational improvements were more limited.

Population Well-Being Measures Help Explain Geographic Disparities In Life Expectancy At The County Level

PubMed Central

Arora, Anita; Spatz, Erica; Herrin, Jeph; Riley, Carley; Roy, Brita; Kell, Kenneth; Coberley, Carter; Rula, Elizabeth; Krumholz, Harlan M.

2016-01-01

Geographic disparities in life expectancy are substantial and not fully explained by differences in race and socioeconomic status. To develop policies that address these inequalities, it is essential to identify other factors that account for this variation. In this study we investigated whether population well-being—a comprehensive measure of physical, mental, and social health—helps explain geographic variation in life expectancy. At the county level, we found that for every 1-standarddeviation (4.2-point) increase in the well-being score, life expectancy was 1.9 years higher for females and 2.6 years higher for males. Life expectancy and well-being remained positively associated, even after race, poverty, and education were controlled for. In addition, well-being partially mediated the established associations of race, poverty, and education with life expectancy. These findings highlight well-being as an important metric of a population’s health and longevity and as a promising focus for intervention. PMID:27834249

Inequality reversal: Effects of the savings propensity and correlated returns

NASA Astrophysics Data System (ADS)

Chakrabarti, Anindya S.; Chakrabarti, Bikas K.

2010-09-01

In the last decade, a large body of literature has been developed to explain the universal features of inequality in terms of income and wealth. By now, it is established that the distributions of income and wealth in various economies show a number of statistical regularities. There are several models to explain such static features of inequality in a unifying framework, and the kinetic exchange models in particular provide one such framework. Here we focus on the dynamic features of inequality. In the process of development and growth, inequality in an economy in terms of income and wealth follows a particular pattern of rising in the initial stage followed by an eventual fall. This inverted U-shaped curve is known as the Kuznets Curve. We examine the possibilities of such behavior of an economy in the context of a generalized kinetic exchange model. It is shown that under some specific conditions, our model economy indeed shows inequality reversal.

Inequalities in utilisation of general practitioner and specialist services in 9 European countries.

PubMed

Stirbu, Irina; Kunst, Anton E; Mielck, Andreas; Mackenbach, Johan P

2011-10-31

The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. People with lower education used GP services equally often in most countries (except Belgium and Germany) compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. © 2011 Stirbu et al; licensee BioMed Central Ltd.

Inefficient Self-Selection into Education and Wage Inequality

ERIC Educational Resources Information Center

Ordine, Patrizia; Rose, Giuseppe

2011-01-01

This paper proposes a theoretical framework where "within graduates" wage inequality is related to overeducation/educational mismatch in the labor market. We show that wage inequality may arise because of inefficient self-selection into education in the presence of ability-complementary technological progress and asymmetric information…

Absolute and relative educational inequalities in depression in Europe.

PubMed

Dudal, Pieter; Bracke, Piet

2016-09-01

To investigate (1) the size of absolute and relative educational inequalities in depression, (2) their variation between European countries, and (3) their relationship with underlying prevalence rates. Analyses are based on the European Social Survey, rounds three and six (N = 57,419). Depression is measured using the shortened Centre of Epidemiologic Studies Depression Scale. Education is coded by use of the International Standard Classification of Education. Country-specific logistic regressions are applied. Results point to an elevated risk of depressive symptoms among the lower educated. The cross-national patterns differ between absolute and relative measurements. For men, large relative inequalities are found for countries including Denmark and Sweden, but are accompanied by small absolute inequalities. For women, large relative and absolute inequalities are found in Belgium, Bulgaria, and Hungary. Results point to an empirical association between inequalities and the underlying prevalence rates. However, the strength of the association is only moderate. This research stresses the importance of including both measurements for comparative research and suggests the inclusion of the level of population health in research into inequalities in health.

Secondary School Tracking and Educational Inequality: Compensation, Reinforcement, or Neutrality?

ERIC Educational Resources Information Center

Gamoran, Adam; Mare, Robert D.

1989-01-01

Using data from the High School and Beyond Survey, the author examines the effects of secondary educational academic tracking on educational stratification relative to racial, sexual, and socioeconomic inequality. Finds that current tracking practices produce less inequality among Blacks and females. Also finds that noncollege programs are not…

Socioeconomic inequality of unintended pregnancy in the Iranian population: a decomposition approach.

PubMed

Omani-Samani, Reza; Amini Rarani, Mostafa; Sepidarkish, Mahdi; Khedmati Morasae, Esmaeil; Maroufizadeh, Saman; Almasi-Hashiani, Amir

2018-05-09

There are several studies regarding the predictors or risk factors of unintended pregnancy, but only a small number of studies have been carried out concerning the socio-economic factors influencing the unintended pregnancy rate. This study aimed to determine the socioeconomic inequality of unintended pregnancy in Tehran, Iran, as a developing country. In this hospital based cross-sectional study, 5152 deliveries from 103 hospitals in Tehran (the capital of Iran) were included in the analysis in July 2015. Socioeconomic status (SES) was measured through an asset-based method and principal component analysis was carried out to calculate the household SES. The concentration index and curve was used to measure SES inequality in unintended pregnancy, and then decomposed into its determinants. The data was analyzed by statistical Stata software. The Wagstaff normalized concentration index of unintended pregnancy (- 0.108 (95% Confidence Interval (CI) = - 0.119 ~ - 0.054)) endorses that unintended pregnancy is more concentrated among poorer mothers. The results showed that SES accounted for 27% of unintended pregnancy inequality, followed by the mother's nationality (19%), father's age (16%), mother's age (10%), father's education level (7%) and Body Mass Index (BMI) groups (5%). Unintended pregnancy is unequally distributed among Iranian women and is more concentrated among poor women. Economic status had the most positive contribution, explaining 27% of inequality in unintended pregnancy.

The impact of socioeconomic factors on municipal solid waste generation in São Paulo, Brazil.

PubMed

Vieira, Victor H Argentino de Morais; Matheus, Dácio R

2018-01-01

Social factors have not been sufficiently explored in municipal solid waste management studies. Latin America has produced even fewer studies with this approach; technical and economic investigations have prevailed. We explored the impacts of socioeconomic factors on municipal solid waste generation in Greater Sao Paulo, which includes 39 municipalities. We investigated the relations between municipal solid waste generation and social factors by Pearson's correlation coefficient. The Student's t-test (at p ← 0.01) proved significance, and further regression analysis was performed with significant factors. We considered 10 socioeconomic factors: population, rural population, density, life expectancy, education (secondary, high and undergraduate level), income per capita, inequality and human development. A later multicollinearity analysis resulted in the determination of inequality (r p = 0.625) and income per capita (r p = 0.607) as major drivers. The results showed the relevance of considering social aspects in municipal solid waste management and isolated inequality as an important factor in planning. Inequality must be used as a complementary factor to income, rather than being used exclusively. Inequality may explain differences of waste generation between areas with similar incomes because of consumption patterns. Therefore, unequal realities demand unequal measures to avoid exacerbation, for example, pay-as-you-throw policies instead of uniform fees. Unequal realities also highlight the importance of tiering policies beyond the waste sector, such as sustainable consumption.

Inequalities in social capital and health between people with and without disabilities.

PubMed

Mithen, Johanna; Aitken, Zoe; Ziersch, Anne; Kavanagh, Anne M

2015-02-01

The poor mental and physical health of people with disabilities has been well documented and there is evidence to suggest that inequalities in health between people with and without disabilities may be at least partly explained by the socioeconomic disadvantage (e.g. low education, unemployment) experienced by people with disabilities. Although there are fewer studies documenting inequalities in social capital, the evidence suggests that people with disabilities are also disadvantaged in this regard. We drew on Bourdieu's conceptualisation of social capital as the resources that flow to individuals from their membership of social networks. Using data from the General Social Survey 2010 of 15,028 adults living in private dwellings across non-remote areas of Australia, we measured social capital across three domains: informal networks (contact with family and friends); formal networks (group membership and contacts in influential organisations) and social support (financial, practical and emotional). We compared levels of social capital and self-rated health for people with and without disabilities and for people with different types of impairments (sensory and speech, physical, psychological and intellectual). Further, we assessed whether differences in levels of social capital contributed to inequalities in health between people with and without disabilities. We found that people with disabilities were worse off than people without disabilities in regard to informal and formal networks, social support and self-rated health status, and that inequalities were greatest for people with intellectual and psychological impairments. Differences in social capital did not explain the association between disability and health. These findings underscore the importance of developing social policies which promote the inclusion of people with disabilities, according to the varying needs of people with different impairments types. Given the changing policy environment, ongoing monitoring of the living circumstances of people with disabilities, including disaggregation of data by impairment type, is critical. Copyright © 2014 Elsevier Ltd. All rights reserved.

Inequality of child mortality among ethnic groups in sub-Saharan Africa.

PubMed Central

Brockerhoff, M.; Hewett, P.

2000-01-01

Accounts by journalists of wars in several countries of sub-Saharan Africa in the 1990s have raised concern that ethnic cleavages and overlapping religious and racial affiliations may widen the inequalities in health and survival among ethnic groups throughout the region, particularly among children. Paradoxically, there has been no systematic examination of ethnic inequality in child survival chances across countries in the region. This paper uses survey data collected in the 1990s in 11 countries (Central African Republic, Côte d'Ivoire, Ghana, Kenya, Mali, Namibia, Niger, Rwanda, Senegal, Uganda, and Zambia) to examine whether ethnic inequality in child mortality has been present and spreading in sub-Saharan Africa since the 1980s. The focus was on one or two groups in each country which may have experienced distinct child health and survival chances, compared to the rest of the national population, as a result of their geographical location. The factors examined to explain potential child survival inequalities among ethnic groups included residence in the largest city, household economic conditions, educational attainment and nutritional status of the mothers, use of modern maternal and child health services including immunization, and patterns of fertility and migration. The results show remarkable consistency. In all 11 countries there were significant differentials between ethnic groups in the odds of dying during infancy or before the age of 5 years. Multivariate analysis shows that ethnic child mortality differences are closely linked with economic inequality in many countries, and perhaps with differential use of child health services in countries of the Sahel region. Strong and consistent results in this study support placing the notion of ethnicity at the forefront of theories and analyses of child mortality in Africa which incorporate social, and not purely epidemiological, considerations. Moreover, the typical advantage of relatively small, clearly defined ethnic groups, as compared to the majority in the national population, according to fundamental indicators of wellbeing--child survival, education, housing, and so forth--suggests that many countries in sub-Saharan Africa, despite their widespread poverty, are as marked by social inequality as are countries in other regions in the world. PMID:10686731

Who Decided College Access in Chinese Secondary Education? Rural-Urban Inequality of Basic Education in Contemporary China

ERIC Educational Resources Information Center

Li, Jian

2016-01-01

This paper investigates the rural-urban inequalities in basic education of contemporary China. The China Education Panel Survey (2013-2014) (CEPS) was utilized to analyze the gaps between rural and urban inequality in junior high schools in terms of three domains, which include the equalities of access, inputs, and outcomes. From the sociocultural…

A Multination Study of Socioeconomic Inequality in Expectations for Progression to Higher Education: The Role of Between-School Tracking and Ability Stratification

ERIC Educational Resources Information Center

Parker, Philip D.; Jerrim, John; Schoon, Ingrid; Marsh, Herbert W.

2016-01-01

Persistent inequalities in educational expectations across societies are a growing concern. Recent research has explored the extent to which inequalities in education are due to primary effects (i.e., achievement differentials) versus secondary effects (i.e., choice behaviors net of achievement). We explore educational expectations in order to…

Sociopolitical Change and Inequality of Educational Opportunities: Influences of Family Background and Institutional Factors on the Acquisition of Education (1940-2001)

ERIC Educational Resources Information Center

Chunling, Li

2012-01-01

This article analyzes the influences of family background and institutional factors on the acquisition of education (1940-2001) and demonstrates that the increase or decrease in the inequality of educational opportunity allocations are closely linked to the government's relevant policies. The rapid growth of the inequality in educational…

Educational inequalities in self-rated health across US states and European countries.

PubMed

Präg, Patrick; Subramanian, S V

2017-07-01

The US shows a distinct health disadvantage when compared to other high-income nations. A potential lever to reduce this disadvantage is to improve the health situation of lower socioeconomic groups. Our objective is to explore how the considerable within-US variation in health inequalities compares to the health inequalities across other Western countries. Representative survey data from 44 European countries and the US federal states were obtained from the fourth wave of the European Values Study (EVS) and the 2008 wave of the Behavioral Risk Factor Surveillance System. Using binary logistic regression, we analyze different forms of educational inequalities in self-rated health (SRH), adjusted for age and sex. The extent of educational inequalities in SRH varies considerably over European countries and US states; with US states in general showing greater inequality, however, differences between US states and European countries are less clear than commonly assumed. The US has considerable differences in educational inequalities in SRH across geographic locations. To understand the reasons for the US health disadvantage, comparative research has to take into account the vast variation in health inequalities within the US.

Do Brothers Affect Their Sisters' Chances to Graduate? An Analysis of Sibling Sex Composition Effects on Graduation from a University or a "Fachhochschule" in Germany

ERIC Educational Resources Information Center

Jacob, Marita

2011-01-01

In a recent paper on gender inequality in higher education Buchman and DiPrete (2006) assume that the decrease in the gender gap in college completion in the US can partly be explained by changes in the allocation of familial resources in favour of women. However, they do not test this hypothesis empirically. In this paper I examine the effects of…

Inequality in OECD countries.

PubMed

Thévenot, Celine

2017-08-01

This article recalls the state of play of inequality levels and trends in OECD countries, with a special focus on Nordic countries. It sheds light on explaining the drivers of the rise in inequality and its economic consequences. It addresses in particular the issue of redistribution through taxes and transfers. It concludes with an overview of policy packages that should be considered to address the issue of rising inequalities.

Disadvantaged populations in maternal health in China who and why?

PubMed

Yuan, Beibei; Qian, Xu; Thomsen, Sarah

2013-04-03

China has made impressive progress towards the Millennium Development Goal (MDG) for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Inequity in maternal health continues to be an issue worthy of greater programmatic and monitoring efforts in China.

Inequality, poverty and development.

PubMed

Ahluwalia, M S

1976-12-01

Dicussion explores the nature of the relationship between the distribution of income and the process of development on the basis of cross country data on income inequality. The results presented are based on a sample of 60 countries, including 40 developing countries, 14 developed countries, and 6 socialist countries. The approach adopted is essentially exploratory. Multivariate regression analysis was used to estimate cross country relationships between the income shares of different percentile groups and selected variables reflecting aspects of the development process which are likely to influence income inequality. The estimated equations are then used as a basis for broad generalizations about the relationship between income distribution and development. There was strong support for the proposition that relative inequaltiy increases substantially in the early stages of development, with a reversal of this tendency in the later stages. The propositions held whether the sample was restricted to developing countries or expanded to include developed and socialist countries. The process was most prolonged for the poorest group. There were a number of processes occurring "pari passu" with development which were correlated with income inequality and which can plausibly be interpreted as causal. These were intersectoral shifts in the structure of production, expansion in education attainment and skill level of the labor force; and reduction in the growth of population. The operation of these processes appeared to explain some of the improvement in income distribution observed in the later stages of development, but they did not serve to explain the marked deterioration observed in the earlier stages. The cross section results failed to support the stronger hypothesis that the deterioration in relative inequality reflected a prolonged absolute impoverishment of large sections of the population in the course of development. The cross country pattern showed average absolute incomes of the lower percentile groups rising as per capita gross national product rises, although slower than for upper income groups. The cross section results failed to support the view that a faster rate of growth is systematically associated with higher inequality than can be expected given the state of development realized. An appendix identifies data sources and problems.

Pre-Service Teachers' Linear and Quadratic Inequalities Understandings

ERIC Educational Resources Information Center

Bicer, Ali; Capraro, Robert M.; Capraro, Mary M.

2014-01-01

The National Council of Teachers of Mathematics [NCTM] noted that middle and high school students are expected to be able to both explain inequalities by using mathematical symbols and understand meanings by interpreting the solutions of inequalities. Unfortunately, research has revealed that not only do middle and high school students hold…

Inequalities in oral impacts and welfare regimes: analysis of 21 European countries.

PubMed

Guarnizo-Herreño, Carol C; Watt, Richard G; Pikhart, Hynek; Sheiham, Aubrey; Tsakos, Georgios

2014-12-01

Very few studies have analysed the relationship between political factors and oral health inequalities, and only one study has compared the magnitude of inequalities in oral health-related quality of life (OHRQoL) across welfare state regimes. This study aimed to compare socioeconomic inequalities in oral impacts on daily life among 21 European countries with different welfare state regimes (Scandinavian, Anglo-Saxon, Bismarckian, Southern, and Eastern). We analysed data from the Eurobarometer 72.3, a survey carried out in 2009 among adults in European countries. Inequalities in oral impacts by education, occupational social class and subjective social status (SSS) were estimated by means of age-standardized prevalence rates, odds ratios (ORs), the relative index of inequality (RII) and the slope index of inequality (SII). Educational inequalities in the form of social gradients were observed in all welfare regimes. The Scandinavian and Southern welfare regimes also showed gradients for all SEP measures. There were not significant differences in the magnitude of relative inequalities (RII) across welfare state regimes. Absolute educational inequalities were largest in the Anglo-Saxon welfare regime (SII = 17.57; 95% CI: 7.80-27.33) and smallest in the Bismarckian (SII = 3.32; 95% CI: -2.18 to 8.83). A significant difference in the magnitude of inequalities across welfare regimes was found for absolute educational inequalities but not for relative inequalities. Welfare state regimes may influence the relationship between knowledge-related resources and oral impacts on daily life. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Educational inequalities in 28 day and 1-year mortality after hospitalisation for incident acute myocardial infarction--a nationwide cohort study.

PubMed

Igland, Jannicke; Vollset, Stein Emil; Nygård, Ottar K; Sulo, Gerhard; Sulo, Enxhela; Ebbing, Marta; Næss, Øyvind; Ariansen, Inger; Tell, Grethe S

2014-12-20

There is little recent evidence on the impact of comorbidities and access to revascularisation procedures on educational inequalities in mortality after acute myocardial infarction (AMI). The aim of the study was to investigate educational inequalities in mortality among all patients hospitalised for an incident AMI during 2001-2009 in Norway. Data were obtained through the Cardiovascular Disease in Norway (CVDNOR) project. Incident AMI was defined as an AMI-hospitalisation without any AMI-events in the previous 7 years. Education was categorised as basic, upper secondary or tertiary (college/university). Cox regression was used to assess educational differences in 28-day and 29-365-day mortality after an incident AMI in terms of hazard ratios and relative index of inequality (RII). RII can be interpreted as the ratio in mortality between the 0 th and the 100th percentile of the education distribution. 111 993 incident AMIs were included (39.4% women). Among patients aged 35-69, RIIs (95% CI) adjusted for age, sex and year were 1.86 (1.59-2.18) and 2.10 (1.69-2.59) for 28-day and 29-365-day mortality respectively. Among patients aged 70-94 the corresponding RIIs were 1.12 (1.06-1.30) and 1.28 (1.19-1.38). Educational inequalities in mortality were attenuated after adjustment for comorbidities and revascularisation, but were still significant. Educational inequalities did not decrease during 2001-2009. Educational inequalities in both 28-day and 29-365 day mortality were strong and persistent during 2001-2009. Further research is needed to investigate if these disparities are driven by inequalities in the severity of the AMI or by inequitable access to treatment and rehabilitation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Intelligence and the explanation for socio-economic inequalities in health].

PubMed

Huisman, M; Mackenbach, J P

2007-05-12

Attention is increasingly being paid to the role of cognitive ability to explain socio-economic inequalities in health. The universal socio-economic gradient in health, where each rung lower on the socio-economic ladder implies worse health, has still not been satisfactorily explained scientifically. Because cognitive ability is related to a multitude of social outcomes in a similarly graded manner, hypothesising that cognitive ability plays a major role in health inequalities by socio-economic status is appealing. Recent empirical studies have shown that at least part of socio-economic health inequalities can indeed be explained by differences in cognitive ability. However, this does not imply that we should be pessimistic about future attempts to break the chain that links socio-economic status and cognitive ability with health. During some life stages, environmental factors may be able to influence cognitive ability. Interventions may therefore be targeted in order to optimize these effects. In addition, there is evidence that cognitive ability is correlated with health-related behaviours such as smoking, excessive alcohol consumption and obesity. Therefore, another opportunity for reducing health inequalities related to cognitive ability and socio-economic status would be to develop tailored interventions to improve health-related behaviours in disadvantaged groups. However, the first priority is to further investigate the role of cognitive ability in health inequalities by examining various health outcomes, different age groups and variations across the life course.

How robust is the calculation of health inequality trends by educational attainment in England and Wales using the Longitudinal Study?

PubMed

Flanagan, L; McCartney, G

2015-06-01

Inequalities in mortality by educational attainment are wider in Eastern Europe than in West and Central Europe, but have thus far been largely limited to cross-sectional analyses. This study explored the potential to use the Longitudinal Study to describe trends in mortality inequality by educational attainment in England and Wales from 1971 to 2009 and the limitations in the available data. Comparison of cohort studies. Data from the Office for National Statistics Longitudinal Study were used which takes a sample of respondees from each Census (1971-2001) and links them to death certification. Age-standardized mortality was calculated by educational attainment for those aged 25-69 years as was the Relative Index of Inequality and Slope Index of Inequality for men and women for each time period. Overall mortality declined in all categories of educational attainment for men and women from 1971. Limited data were collected on educational attainment in the Censuses prior to 2001, combined with the high proportion of respondents with missing data or reporting 'no education', meant that estimates of inequalities for the period 1971 to 2000 were very imprecise and likely to be misleading. For 2001-2009, the slope index of inequality was 268 (95% CI 57-478) and relative index of inequality was 0.61 (95% CI 0.13-1.10) for the total population; 354 (95% CI 72-636) and 0.67 (95% CI 0.14-1.21) respectively for men; and 231 (95% CI 72-389) and 0.66 (95% CI 0.21-1.11) respectively for women. Limited educational data in the Censuses prior to 2001 makes calculation of mortality inequalities by educational attainment in England and Wales imprecise and potentially misleading. International comparisons and time trend analyses using these data prior to 2001 should be done with great caution. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

What explains gender inequalities in HIV/AIDS prevalence in sub-Saharan Africa? Evidence from the demographic and health surveys.

PubMed

Sia, Drissa; Onadja, Yentéma; Hajizadeh, Mohammad; Heymann, S Jody; Brewer, Timothy F; Nandi, Arijit

2016-11-03

Women are disproportionally affected by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in sub-Saharan Africa (SSA). The determinants of gender inequality in HIV/AIDS may vary across countries and require country-specific interventions to address them. This study aimed to identify the socio-demographic and behavioral characteristics underlying gender inequalities in HIV/AIDS in 21 SSA countries. We applied an extension of the Blinder-Oaxaca decomposition approach to data from Demographic and Health Surveys and AIDS Indicator Surveys to quantify the differences in HIV/AIDS prevalence between women and men attributable to socio-demographic factors, sexual behaviours, and awareness of HIV/AIDS. We decomposed gender inequalities into two components: the percentage attributable to different levels of the risk factors between women and men (the "composition effect") and the percentage attributable to risk factors having differential effects on HIV/AIDS prevalence in women and men (the "response effect"). Descriptive analyses showed that the difference between women and men in HIV/AIDS prevalence varied from a low of 0.68 % (P = 0.008) in Liberia to a high of 11.5 % (P < 0.001) in Swaziland. The decomposition analysis showed that 84 % (P < 0.001) and 92 % (P < 0.001) of the higher prevalence of HIV/AIDS among women in Uganda and Ghana, respectively, was explained by the different distributions of HIV/AIDS risk factors, particularly age at first sex between women and men. In the majority of countries, however, observed gender inequalities in HIV/AIDS were chiefly explained by differences in the responses to risk factors; the differential effects of age, marital status and occupation on prevalence of HIV/AIDS for women and men were among the significant contributors to this component. In Cameroon, Guinea, Malawi and Swaziland, a combination of the composition and response effects explained gender inequalities in HIV/AIDS prevalence. The factors that explain gender inequality in HIV/AIDS in SSA vary by country, suggesting that country-specific interventions are needed. Unmeasured factors also contributed substantially to the difference in HIV/AIDS prevalence between women and men, highlighting the need for further study.

Changes and inequalities in early birth registration and childhood care and education in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2006 and 2011

PubMed Central

Giang, Kim Bao; Oh, Juhwan; Kien, Vu Duy; Hoat, Luu Ngoc; Choi, Sugy; Lee, Chul Ou; Van Minh, Hoang

2016-01-01

Introduction Early birth registration, childhood care, and education are essential rights for children and are important for their development and education. This study investigates changes and socioeconomic inequalities in early birth registration and indicators of care and education in children aged under 5 years in Vietnam. Design The analyses reported here used data from the Vietnam Multiple Indicator Cluster Surveys (MICS) in 2006 and 2011. The sample sizes in 2006 and 2011 were 2,680 and 3,678 for children under 5 years of age. Four indicators of childcare and preschool education were measured: birth registration, possession of books, preschool education attendance, and parental support for early childhood education. The concentration index (CI) was used to measure inequalities in gender, maternal education, geographical area, place of residence, ethnicity, and household wealth. Results There were some improvements in birth registration (86.4% in 2006; 93.8% in 2011), preschool education attendance (57.1% in 2006; 71.9% in 2011), and parental support for early childhood education (68.9 and 76.8%, respectively). However, the possession of books was lower (24.7% in 2006; 19.6% in 2011) and became more unequal over time (i.e. CI=0.370 in 2006; CI=0.443 in 2011 in wealth inequality). Inequalities in the care and education of children were still persistent. The largest inequalities were for household wealth and rural versus urban areas. Conclusion Although there have been some improvements in this area, inequalities still exist. Policy efforts in Vietnam should be directed towards closing the gap between different socioeconomic groups for the care and education of children under 5 years old. PMID:26950564

Comparative appraisal of educational inequalities in overweight and obesity among adults in 19 European countries.

PubMed

Roskam, Albert-Jan R; Kunst, Anton E; Van Oyen, Herman; Demarest, Stefaan; Klumbiene, Jurate; Regidor, Enrique; Helmert, Uwe; Jusot, Florence; Dzurova, Dagmar; Mackenbach, Johan P

2010-04-01

In Western societies, a lower educational level is often associated with a higher prevalence of overweight and obesity. However, there may be important international differences in the strength and direction of this relationship, perhaps in respect of differing levels of socio-economic development. We aimed to describe educational inequalities in overweight and obesity across Europe, and to explore the contribution of level of socio-economic development to cross-national differences in educational inequalities in overweight and obese adults in Europe. Cross-sectional data, based on self-reports, were derived from national health interview surveys from 19 European countries (N = 127 018; age range = 25-44 years). Height and weight data were used to calculate the body mass index (BMI). Multivariate regression analysis was employed to measure educational inequalities in overweight and obesity, based on BMI. Gross domestic product (GDP) per capita was used as a measure of level of socio-economic development. Inverse educational gradients in overweight and obesity (i.e. higher education, less overweight and obesity) are a generalized phenomenon among European men and even more so among women. Baltic and eastern European men were the exceptions, with weak positive associations between education and overweight and obesity. Educational inequalities in overweight and obesity were largest in Mediterranean women. A 10 000-euro increase in GDP was related to a 3% increase in overweight and obesity for low-educated men, but a 4% decrease for high-educated men. No associations with GDP were observed for women. In most European countries, people of lower educational attainment are now most likely to be overweight or obese. An increasing level of socio-economic development was associated with an emergence of inequalities among men, and a persistence of these inequalities among women.

Neighborhood education inequality and drinking behavior.

PubMed

Lê, Félice; Ahern, Jennifer; Galea, Sandro

2010-11-01

The neighborhood distribution of education (education inequality) may influence substance use among neighborhood residents. Using data from the New York Social Environment Study (conducted in 2005; n=4000), we examined the associations of neighborhood education inequality (measured using Gini coefficients of education) with alcohol use prevalence and levels of alcohol consumption among alcohol users. Analyses were adjusted for neighborhood education level, income level and income inequality, as well as for individual demographic and socioeconomic characteristics and history of drinking prior to residence in the current neighborhood. Neighborhood social norms about drinking were examined as a possible mediator. In adjusted generalized estimating equation regression models, one-standard-deviation-higher education inequality was associated with 1.18 times higher odds of alcohol use (logistic regression odds ratio=1.18, 95% confidence interval 1.08-1.30) but 0.79 times lower average daily alcohol consumption among alcohol users (Poisson regression relative rate=0.79, 95% confidence interval 0.68-0.92). The results tended to differ in magnitude depending on respondents' individual educational levels. There was no evidence that these associations were mediated by social drinking norms, although norms did vary with education inequality. Our results provide further evidence of a relation between education inequality and drinking behavior while illustrating the importance of considering different drinking outcomes and heterogeneity between neighborhood subgroups. Future research could fruitfully consider other potential mechanisms, such as alcohol availability or the role of stress; research that considers multiple mechanisms and their combined effects may be most informative. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Socioeconomic inequality in neonatal mortality in countries of low and middle income: a multicountry analysis.

PubMed

McKinnon, Britt; Harper, Sam; Kaufman, Jay S; Bergevin, Yves

2014-03-01

Neonatal mortality rates (NMRs) in countries of low and middle income have been only slowly decreasing; coverage of essential maternal and newborn health services needs to increase, particularly for disadvantaged populations. Our aim was to produce comparable estimates of changes in socioeconomic inequalities in NMR in the past two decades across these countries. We used data from Demographic and Health Surveys (DHS) for countries in which a survey was done in 2008 or later and one about 10 years previously. We measured absolute inequalities with the slope index of inequality and relative inequalities with the relative index of inequality. We used an asset-based wealth index and maternal education as measures of socioeconomic position and summarised inequality estimates for all included countries with random-effects meta-analysis. 24 low-income and middle-income countries were eligible for inclusion. In most countries, absolute and relative wealth-related and educational inequalities in NMR decreased between survey 1 and survey 2. In five countries (Cameroon, Nigeria, Malawi, Mozambique, and Uganda), the difference in NMR between the top and bottom of the wealth distribution was reduced by more than two neonatal deaths per 1000 livebirths per year. By contrast, wealth-related inequality increased by more than 1·5 neonatal deaths per 1000 livebirths per year in Ethiopia and Cambodia. Patterns of change in absolute and relative educational inequalities in NMR were similar to those of wealth-related NMR inequalities, although the size of educational inequalities tended to be slightly larger. Socioeconomic inequality in NMR seems to have decreased in the past two decades in most countries of low and middle income. However, a substantial survival advantage remains for babies born into wealthier households with a high educational level, which should be considered in global efforts to further reduce NMR. Canadian Institutes of Health Research. Copyright © 2014 McKinnon et al. Open Access article distributed under the terms of CC BY. Published by .. All rights reserved.

A critical review of social and health inequalities in the nursing curriculum.

PubMed

Rozendo, Célia Alves; Santos Salas, Anna; Cameron, Brenda

2017-03-01

Social and health inequalities are a reality around the world and one of the most important challenges in the current age. Nurse educators can respond to these challenges by incorporating curricular components to identify and intervene in social and health inequalities. To examine how social and health inequalities have been addressed in the nursing curriculum. Informed by the work of Paulo Freire, a critical literature review was performed to examine how social and health inequalities have been addressed in the nursing curriculum. In July 2015, we searched for articles published from 2000 to 2015 in ERIC, CINAHL, Web of Science, Scielo, MEDLINE and LILACS databases. Main search terms included "disparity" or "inequality" and "curriculum" and "nursing." We included studies published in academic journals in English, Portuguese and Spanish. A total of 20 articles were included in this review. Most of the articles (15) were from the United States and described educational experiences in implementing courses in nursing undergraduate curricula. Limited experiences with graduate nursing education were identified. Social and health inequalities were approached in these articles through elements such as social justice, cultural competence, cultural safety, and advocacy. A concern to reduce social and health disparities was noted. We identified three major themes in the articles included in this review: 1) elements in the curricula that can contribute to reducing social and health inequalities; 2) educational and research strategies used to address the theme of inequalities; 3) a focus on socially vulnerable populations to increase awareness on social and health inequalities. Findings suggest that nursing education initiatives align with the recommendations from the World Health Organization to address disparities. There is also a need to identify existing conceptual and practical content on inequalities in the nursing curriculum through future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Educational inequalities in health in European welfare states: a social expenditure approach.

PubMed

Dahl, Espen; van der Wel, Kjetil A

2013-03-01

A puzzle in comparative health inequality research is the finding that egalitarian welfare states do not necessarily demonstrate narrow health inequalities. This paper interrogates into this puzzle by moving beyond welfare regimes to examine how welfare spending affect inequalities in self-rated across Europe. We operationalise welfare spending in four different ways and compare both absolute and relative health inequalities, as well as the level of poor self-rated health in the low education group across varying levels of social spending. The paper employs data from the EU Statistics of Income and Living Conditions (EU-SILC) and includes a sample of approximately 245,000 individuals aged 25-80+ years from 18 European countries. The data were examined by means of gender stratified multilevel logistic regression analyses. The results show that social expenditures are associated with lower health inequalities among women and, to a lesser degree, among men. Especially those with primary education benefit from high social transfers as compared with those who have tertiary education. This means that lower educational inequalities in health - in absolute and relative terms- are linked to higher social spending. The four different operationalisations of social spending produce similar patterns. Copyright © 2012 Elsevier Ltd. All rights reserved.

Relative health effects of education, socioeconomic status and domestic gender inequity in Sweden: a cohort study.

PubMed

Phillips, Susan P; Hammarström, Anne

2011-01-01

Limited existing research on gender inequities suggests that for men workplace atmosphere shapes wellbeing while women are less susceptible to socioeconomic or work status but vulnerable to home inequities. Using the 2007 Northern Swedish Cohort (n = 773) we identified relative contributions of perceived gender inequities in relationships, financial strain, and education to self-reported health to determine whether controlling for sex, examining interactions between sex and other social variables, or sex-disaggregating data yielded most information about sex differences. Men had lower education but also less financial strain, and experienced less gender inequity. Overall, low education and financial strain detracted from health. However, sex-disaggregated data showed this to be true for women, whereas for men only gender inequity at home affected health. In the relatively egalitarian Swedish environment where women more readily enter all work arenas and men often provide parenting, traditional primacy of the home environment (for women) and the work environment (for men) in shaping health is reversing such that perceived domestic gender inequity has a significant health impact on men, while for women only education and financial strain are contributory. These outcomes were identified only when data were sex-disaggregated.

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992-2003.

PubMed

Puigpinós, Rosa; Borrell, Carme; Antunes, José Leopoldo Ferreira; Azlor, Enric; Pasarín, M Isabel; Serral, Gemma; Pons-Vigués, Mariona; Rodríguez-Sanz, Maica; Fernández, Esteve

2009-01-23

The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992-1994, 1995-1997, 1998-2000, and 2001-2003). Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer.

Full Service Extended Schools and Educational Inequality in Urban Contexts--New Opportunities for Progress?

ERIC Educational Resources Information Center

Raffo, Carlo; Dyson, Alan

2007-01-01

This paper examines the extent to which the UK government's full service extended schools programme has the capacity to ameliorate educational inequality in urban contexts. It starts by examining a variety of explanatory narratives for educational inequality in urban contexts in the UK and suggests that the dynamics of social exclusion created by…

Does Expanding Higher Education Reduce Income Inequality in Emerging Economy? Evidence from Pakistan

ERIC Educational Resources Information Center

Qazi, Wasim; Raza, Syed Ali; Jawaid, Syed Tehseen; Karim, Mohd Zaini Abd

2018-01-01

This study investigates the impact of development in the higher education sector, on the Income Inequality in Pakistan, by using the annual time series data from 1973 to 2012. The autoregressive distributed lag bound testing co-integration approach confirms the existence of long-run relationship between higher education and income inequality.…

Time trends in absolute and relative socioeconomic inequalities in leisure time physical inactivity in northern Sweden.

PubMed

Szilcz, Máté; Mosquera, Paola A; Sebastián, Miguel San; Gustafsson, Per E

2018-02-01

The aim was to investigate the time trends in educational, occupational, and income-related inequalities in leisure time physical inactivity in 2006, 2010, and 2014 in northern Swedish women and men. This study was based on data obtained from the repeated cross-sectional Health on Equal Terms survey of 2006, 2010, and 2014. The analytical sample consisted of 20,667 (2006), 31,787 (2010), and 21,613 (2014) individuals, aged 16-84. Logistic regressions were used to model the probability of physical inactivity given a set of explanatory variables. Slope index of inequality (SII) and relative index of inequality (RII) were used as summary measures of the social gradient in physical inactivity. The linear trend in inequalities and difference between gender and years were estimated by interaction analyses. The year 2010 displayed the highest physical inactivity inequalities for all socioeconomic position indicators, but educational and occupational inequalities decreased in 2014. However, significant positive linear trends were found in absolute and relative income inequalities. Moreover, women had significantly higher RII of education in physical inactivity in 2014 and significantly higher SII and RII of income in physical inactivity in 2010, than did men in the same years. The recent reduction in educational and occupational inequalities following the high inequalities around the time of the great recession in 2010 suggests that the current policies might be fairly effective. However, to eventually alleviate inequities in physical inactivity, the focus of the researchers and policymakers should be directed toward the widening trends of income inequalities in physical inactivity.

Inequality in Participation in Adult Learning and Education (ALE): Effects of Micro- and Macro-Level Factors through a Comparative Study

ERIC Educational Resources Information Center

Lee, Jeongwoo

2017-01-01

The objectives of this dissertation include describing and analyzing the patterns of inequality in ALE participation at both the micro and macro levels. Special attention is paid to social origins of individual adults and their association with two groups of macro-level factors, social inequality (income, education, and skill inequality) and…

Are occupational factors important determinants of socioeconomic inequalities in musculoskeletal pain?

PubMed

Mehlum, Ingrid Sivesind; Kristensen, Petter; Kjuus, Helge; Wergeland, Ebba

2008-08-01

The aim of this study was to quantify socioeconomic inequalities in low-back pain, neck-shoulder pain, and arm pain in the general working population in Oslo and to examine the impact of job characteristics on these inequalities. All economically active 30-, 40-, and 45-year-old persons who attended the Oslo health study in 2000-2001 and answered questions on physical job demands, job autonomy, and musculoskeletal pain were included (N=7293). Occupational class was used as an indicator of socioeconomic status. The lower occupational classes were compared with higher grade professionals, and prevalences, prevalence ratios, prevalence differences, and population attributable fractions were calculated. There were marked, stepwise socioeconomic gradients for musculoskeletal pain, steeper for the men than for the women. The relative differences (prevalence ratios) were larger for low-back pain and arm pain than for neck-shoulder pain. The absolute differences (prevalence differences) were the largest for low-back pain. Physical job demands explained a substantial proportion of the absolute occupational class inequalities in low-back pain, while job autonomy was more important in explaining the inequalities in neck-shoulder pain and arm pain. The estimated population attributable fractions supported the impact of job characteristics at the working population level, especially for low-back pain. In this cross-sectional study, physical job demands and job autonomy explained a substantial proportion of occupational class inequalities in self-reported musculoskeletal pain in the working population in Oslo. This finding indicates that the workplace may be an important arena for preventive efforts to reduce socioeconomic inequalities in musculoskeletal pain.

Work conditions and socioeconomic inequalities in work ability.

PubMed

Aittomäki, Akseli; Lahelma, Eero; Roos, Eva

2003-04-01

The objective of this study was to investigate socioeconomic inequalities in work ability among municipal employees and the contribution of work conditions to these inequalities. The subjects were employees of the City of Helsinki and were all over 40 years of age. Data (N=1,827) were collected in the age-group-based medical check-ups by occupational health personnel. Work ability was measured with a work ability index. The association between the work ability index with socioeconomic status was examined by fitting logistic regression models. There was a consistent gradient in work ability, lower socioeconomic groups having poorer work ability. Adjusting for physical stress accounted for a substantial part of the socioeconomic inequalities. Adjusting for possibilities for influence and development at work accounted for some of the difference between white-collar and blue-collar employees, but not for differences between the white-collar subgroups among the women. Mental stress and problems in the social environment were not clearly associated with the inequalities. Socioeconomic inequalities in work ability among municipal employees correspond to the inequalities in ill health found in general populations. Physical stress at work explained a large part of the inequality. Poor possibilities to influence one's work contributed to the excess of lowered work ability among the blue-collar employees, but not to the inequalities between white-collar subgroups of women. Apart from physical workload, work conditions did not explain socioeconomic inequalities between white-collar subgroups of women.

Students' Understandings and Misconceptions of Algebraic Inequalities

ERIC Educational Resources Information Center

Rowntree, Rebecca V.

2009-01-01

The National Council of Teachers of Mathematics [NCTM] requires students in grades nine through 12 to be able to explain inequalities using mathematical relational symbols and be able to understand the meaning of inequalities and their solutions (NCTM, 2000). Studies have shown that not only middle and high school students have difficulties with…

Measuring and decomposing inequity in self-reported morbidity and self-assessed health in Thailand.

PubMed

Yiengprugsawan, Vasoontara; Lim, Lynette Ly; Carmichael, Gordon A; Sidorenko, Alexandra; Sleigh, Adrian C

2007-12-18

In recent years, interest in the study of inequalities in health has not stopped at quantifying their magnitude; explaining the sources of inequalities has also become of great importance. This paper measures socioeconomic inequalities in self-reported morbidity and self-assessed health in Thailand, and the contributions of different population subgroups to those inequalities. The Health and Welfare Survey 2003 conducted by the Thai National Statistical Office with 37,202 adult respondents is used for the analysis. The health outcomes of interest derive from three self-reported morbidity and two self-assessed health questions. Socioeconomic status is measured by adult-equivalent monthly income per household member. The concentration index (CI) of ill health is used as a measure of socioeconomic health inequalities, and is subsequently decomposed into contributing factors. The CIs reveal inequality gradients disadvantageous to the poor for both self-reported morbidity and self-assessed health in Thailand. The magnitudes of these inequalities were higher for the self-assessed health outcomes than for the self-reported morbidity outcomes. Age and sex played significant roles in accounting for the inequality in reported chronic illness (33.7 percent of the total inequality observed), hospital admission (27.8 percent), and self-assessed deterioration of health compared to a year ago (31.9 percent). The effect of being female and aged 60 years or older was by far the strongest demographic determinant of inequality across all five types of health outcome. Having a low socioeconomic status as measured by income quintile, education and work status were the main contributors disadvantaging the poor in self-rated health compared to a year ago (47.1 percent) and self-assessed health compared to peers (47.4 percent). Residence in the rural Northeast and rural North were the main regional contributors to inequality in self-reported recent and chronic illness, while residence in the rural Northeast was the major contributor to the tendency of the poor to report lower levels of self-assessed health compared to peers. The findings confirm that substantial socioeconomic inequalities in health as measured by self-reported morbidity and self-assessed health exist in Thailand. Decomposition analysis shows that inequalities in health status are associated with particular demographic, socioeconomic and geographic population subgroups. Vulnerable subgroups which are prone to both ill health and relative poverty warrant targeted policy attention.

South Asian-White health inequalities in Canada: intersections with gender and immigrant status.

PubMed

Veenstra, Gerry; Patterson, Andrew C

2016-12-01

We apply intersectionality theory to health inequalities in Canada by investigating whether South Asian-White health inequalities are conditioned by gender and immigrant status in a synergistic way. Our dataset comprised 10 cycles (2001-2013) of the Canadian Community Health Survey. Using binary logistic regression modeling, we examined South Asian-White inequalities in self-rated health, diabetes, hypertension and asthma before and after controlling for potentially explanatory factors. Models were calculated separately in subsamples of native-born women, native-born men, immigrant women and immigrant men. South Asian immigrants had higher odds of fair/poor self-rated health, diabetes and hypertension than White immigrants. Native-born South Asian men had higher odds of fair/poor self-rated health than native-born White men and native-born South Asian women had lower odds of hypertension than native-born White women. Education, household income, smoking, physical activity and body mass index did little to explain these associations. The three-way interaction between racial identity, gender and immigrant status approached statistical significance for hypertension but not for self-rated health and asthma. Our findings provide modest support for the intersectionally inspired principle that combinations of identities derived from race, gender and nationality constitute sui generis categories in the manifestation of health outcomes.

Surveillance of Social and Geographic Inequalities in Housing-Related Issues: The Case of the Eastern Townships, Quebec (Canada)

PubMed Central

Roy, Mathieu; Généreux, Mélissa; Laverdière, Émélie; Vanasse, Alain

2014-01-01

Even though health inequalities are conditioned by many aspects of the environment, much of the existing research focuses on the social environment. This emphasis has the effect to neglect other environmental aspects such as its physical dimension. The physical environment, which is linked to housing conditions, may contribute to the uneven distribution of health. In this study, we examined 19 housing-related issues among a representative sample of 2,000 adults residing in a Quebec (Canada) health region characterized by a mix of rural, semi-rural, and urban areas. The distribution of these issues was examined according to socioeconomic and geographic indicators of social position. Summary measures of inequalities were assessed. Our results showed that the prevalence of nearly all housing-related issues was higher among low-income households compared to more affluent ones. Highly educated individuals showed better housing conditions, whereas different issues tended to cluster in deprived or densely populated areas. To conclude, we observed steep gradients between social class and poor housing conditions. This may explain a substantial part of health inequality on the regional scale. The surveillance of housing-related issues is therefore essential to properly inform and mobilize local stakeholders and to develop interventions that target vulnerable groups on this level. PMID:24806192

Information barriers and social stratification in higher education: evidence from a field experiment.

PubMed

Abbiati, Giovanni; Argentin, Gianluca; Barone, Carlo; Schizzerotto, Antonio

2017-11-29

Our contribution assesses the role of information barriers for patterns of participation in Higher Education (HE) and the related social inequalities. For this purpose, we developed a large-scale clustered randomised experiment involving over 9,000 high school seniors from 62 Italian schools. We designed a counseling intervention to correct student misperceptions of the profitability of HE, that is, the costs, economic returns and chances of success of investments in different tertiary programs. We employed a longitudinal survey to test whether treated students' educational trajectories evolved differently relative to a control group. We find that, overall, treated students enrolled less often in less remunerative fields of study in favour of postsecondary vocational programmes. Most importantly, this effect varied substantially by parental social class and level of education. The shift towards vocational programmes was mainly due to the offspring of low-educated parents; in contrast, children of tertiary graduates increased their participation in more rewarding university fields. Similarly, the redistribution from weak fields to vocational programmes mainly involved the children of the petty bourgeoisie and the working class, while upper class students invested in more rewarding university fields. We argue that the status-maintenance model proposed by Breen and Goldthorpe can explain these socially differentiated treatment effects. Overall, our results challenge the claim that student misperceptions contribute to horizontal inequalities in access to HE. © London School of Economics and Political Science 2017.

Gender-based wage differentials among registered dietitians.

PubMed

Pollard, Prudence; Taylor, Maxine; Daher, Noha

2007-01-01

The debate on compensation equity is broad-based, addressing many organizational, personal, and outcome factors. Central to compensation philosophy is the issue of gender equity. Health care, like many other industries, remains fraught with gender inequity in compensation. This inequity is partially explained by choice of practice area. However, much remains unexplained. Health care is a female-dominated industry with most of the women working in the allied health professions (eg, nurses, dietitians, etc). Registered dietitians (RD) may experience wage discrimination, similar to registered nurses, but prior to the present study, the assumption was not tested. Using data from the first comprehensive study of RD compensation, we examined gender equity in total cash compensation to RDs. Data were collected on total cash compensation, and questions focused on career progression and work outcomes. For purposes of our study, we analyzed data on 5,477 full-time RDs. Ninety-six percent were women, the median age was 43, and median total cash compensation for RDs employed in the position for at least 1 year was $45,500.00. Women earned $45,285.00 and men earned $50,250.00. A median wage gap of $4,965.00 between women and men was observed. Variability in total cash compensation to women was best explained by size of budget, years of experience, work setting, and educational level. Variability for men was explained by size of budget, years of experience, educational level, and employer status. Conclusions suggest that given the wage discrimination that female RDs experience, work organizations should evaluate their pay plans to monitor pay equity. Factors that women can manage to receive compensation that is equal to that of the men include size of budgets they manage, years of experience in the field, employer status, work setting, and educational level attained. Findings are useful for career advisers, human resource specialists, compensation specialists, supervisors, RDs, and compensation researchers.

Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries.

PubMed

Huisman, M; Kunst, A E; Mackenbach, J P

2005-04-01

To determine those groups who are at increased risk of smoking related diseases, we assessed in which male and female generations smoking was more prevalent among lower educated groups than among the higher educated, in 11 European countries. Cross sectional analysis of data on smoking, covering the year 1998, from a social survey designed for all member states of the European Union. Higher and lower educated men and women aged 16 years and older from 11 member states of the European Union. Age standardised prevalence rates by education and prevalence odds ratios of current and ever daily smoking comparing lower educated groups with higher educated groups. A north-south gradient in educational inequalities in current and ever daily smoking was observed for women older than 24 years, showing larger inequalities in the northern countries. Such a gradient was not observed for men. A disadvantage for the lower educated in terms of smoking generally occurred later among women than among men. Indications of inequalities in smoking in the age group 16-24 years were observed for all countries, with the exception of women from Greece and Portugal. Preventing and reducing smoking among lower educated subgroups should be a priority of policies aiming to reduce inequalities in health in Europe. If steps are not taken to control tobacco use among the lower educated groups specifically, inequalities in lung cancer and other smoking related diseases should be anticipated in all populations of the European Union, and both sexes.

Rural Education in Mexico: A Gateway to a Better Life

DTIC Science & Technology

2011-10-28

combatting of poverty as a top priority. However, inequities exist within the Mexican education system between those living in urban areas and those living...product-education” to the “target consumer - rural poor” the government must address the inequalities in the system by applying the factors of quality...out of poverty for the rural poor. 15. SUBJECT TERMS Poor Rural Education in Mexico; Educational Inequities Between Urban and Rural Areas

Educational inequalities in mortality by cause of death: first national data for the Netherlands.

PubMed

Kulhánová, Ivana; Hoffmann, Rasmus; Eikemo, Terje A; Menvielle, Gwenn; Mackenbach, Johan P

2014-10-01

Using new facilities for linking large databases, we aimed to evaluate for the first time the magnitude of relative and absolute educational inequalities in mortality by sex and cause of death in the Netherlands. We analyzed data from Dutch Labour Force Surveys (1998-2002) with mortality follow-up 1998-2007 among people aged 30-79 years. We calculated hazard ratios using Cox proportional hazards model, age-standardized mortality rates and partial life expectancy by education. We compared results for the Netherlands with those for other European countries. The relative risk of dying was about two times higher among primary educated men and women as compared to their tertiary educated counterparts, leading to a gap in partial life expectancy of 3.4 years (men) and 2.4 years (women). Inequalities in mortality are similar to those in other countries in North-Western Europe, but inequalities in lung cancer mortality are substantially larger in the Netherlands, particularly among men. The Netherlands has large inequalities in mortality, especially for smoking-related causes of death. These large inequalities require the urgent attention of policy makers.

Redressing Gender Inequalities in Education. A Review of Constraints and Priorities in Malawi, Zambia, and Zimbabwe.

ERIC Educational Resources Information Center

Swainson, Nicola

The causes and manifestations of gender inequalities in education in Malawi, Zambia, and Zimbabwe and policy options for redressing them were examined through a review of literature on the causes, nature, and extent of gender disparities in education in the study region and information on efforts to eliminate gender inequality. Special attention…

Inequalities at the Starting Gate: Cognitive and Noncognitive Skills Gaps between 2010-2011 Kindergarten Classmates. Report

ERIC Educational Resources Information Center

Garcia, Emma

2015-01-01

Inequalities in education outcomes such as test scores or degree attainment have been at the center of education policy debates for decades. Indeed, the first seminal national report on the state of U.S. education--the 1966 Coleman Report--examined some of these inequalities 50 years ago. Since then, researchers have examined performance gaps by…

Education and Cultural Differences: New Perspectives. Reference Books in International Education, Vol. 15. Garland Reference Library of Social Science, Vol. 594.

ERIC Educational Resources Information Center

Ray, Douglas, Ed.; Poonwassie, Deo H., Ed.

This book contains 27 essays and case studies that focus on the potential for education to lessen social inequality in various countries. Three widespread forms of inequality involve aboriginal societies in modern industrial states, long established communities denied full status, and recent immigrants. Chapters are: "Modern Inequality and…

Ethnic Inequality

PubMed Central

Alesina, Alberto; Michalopoulos, Stelios; Papaioannou, Elias

2015-01-01

This study explores the consequences and origins of between-ethnicity economic inequality across countries. First, combining satellite images of nighttime luminosity with the historical homelands of ethnolinguistic groups we construct measures of ethnic inequality for a large sample of countries. We also compile proxies of overall spatial inequality and regional inequality across administrative units. Second, we uncover a strong negative association between ethnic inequality and contemporary comparative development; the correlation is also present when we condition on regional inequality, which is itself related to under-development. Third, we investigate the roots of ethnic inequality and establish that differences in geographic endowments across ethnic homelands explain a sizable fraction of the observed variation in economic disparities across groups. Fourth, we show that ethnic-specific inequality in geographic endowments is also linked to under-development. PMID:27330223

Quantum correlations beyond Tsirelson's bound

NASA Astrophysics Data System (ADS)

Berry, Dominic; Ringbauer, Martin; Fedrizzi, Alessandro; White, Andrew

2014-03-01

Violations of Bell inequalities show that there are correlations that cannot explained by any classical theory. Further violation, beyond Tsirelson's bound, shows that there are correlations that are not explained by quantum mechanics. Such super-quantum correlations would enable violation of information causality, where communication of one bit provides more than one bit of information [Nature 461, 1101 (2009)]. An unavoidable feature of all realistic Bell inequality experiments is loss. If one postselects on successful measurements, unentangled states can violate Bell inequalities. On the other hand, loss can be used to enhance the violation of Bell inequalities for entangled states. This can improve the ability to distinguish between entangled and unentangled states, despite loss. Here we report an optical experiment providing maximal violation of the CHSH-Bell inequality with entangled states. Due to loss and postselection, Tsirelson's bound is also violated. This enables us to more easily distinguish between entangled and unentangled states. In addition, it provides violation of information causality for the postselected data.

Marriage, Work, and Racial Inequalities in Poverty: Evidence from the U.S.

PubMed

Thiede, Brian; Kim, Hyojung; Slack, Tim

2017-10-01

This paper explores recent racial and ethnic inequalities in poverty, estimating the share of racial poverty differentials that can be explained by variation in family structure and workforce participation. The authors use logistic regression to estimate the association between poverty and race, family structure, and workforce participation. They then decompose between-race differences in poverty risk to quantify how racial disparities in marriage and work explain observed inequalities in the log odds of poverty. They estimate that 47.7-48.9% of black-white differences in poverty risk can be explained by between-group variance in these two factors, while only 4.3-4.5% of the Hispanic-white differential in poverty risk can be explained by these variables. These findings underscore the continued association between racial disparities in poverty and those in labor and marriage markets. However, clear racial differences in the origin of poverty suggest that family- and worked-related policy interventions will not have uniformly effective or evenly distributed impacts on poverty reduction.

American Higher Education and Income Inequality

ERIC Educational Resources Information Center

Hill, Catharine B.

2016-01-01

This paper demonstrates that increasing income inequality can contribute to the trends we see in American higher education, particularly in the selective, private nonprofit and public sectors. Given these institutions' selective admissions and commitment to socioeconomic diversity, the paper demonstrates how increasing income inequality leads to…

Effects of Simulated Interventions to Improve School Entry Academic Skills on Socioeconomic Inequalities in Educational Achievement

PubMed Central

Chittleborough, Catherine R; Mittinty, Murthy N; Lawlor, Debbie A; Lynch, John W

2014-01-01

Randomized controlled trial evidence shows that interventions before age 5 can improve skills necessary for educational success; the effect of these interventions on socioeconomic inequalities is unknown. Using trial effect estimates, and marginal structural models with data from the Avon Longitudinal Study of Parents and Children (n = 11,764, imputed), simulated effects of plausible interventions to improve school entry academic skills on socioeconomic inequality in educational achievement at age 16 were examined. Progressive universal interventions (i.e., more intense intervention for those with greater need) to improve school entry academic skills could raise population levels of educational achievement by 5% and reduce absolute socioeconomic inequality in poor educational achievement by 15%. PMID:25327718

Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use.

PubMed

Gomes de Matos, Elena; Kraus, Ludwig; Hannemann, Tessa-Virginia; Soellner, Renate; Piontek, Daniela

2017-11-01

This study estimates cross-country variation in socioeconomic disparities in adolescent alcohol use and identifies country-level characteristics associated with these disparities. The association between socioeconomic status (family wealth and parental education) and alcohol use (lifetime use and episodic heavy drinking) of 15- to 16-year-olds from 32 European countries was investigated. Country-level characteristics were national income, income inequality and per capita alcohol consumption. Multilevel modelling was applied. Across countries, lifetime use was lower in wealthy than in less wealthy families (odds ratio [OR] (girls)  = 0.95, OR (boys)  = 0.94). The risk of episodic heavy drinking, in contrast, was higher for children from wealthier families (OR (girls)  = 1.04, OR (boys)  = 1.08) and lower when parents were highly educated (ORs = 0.95-0.98). Socioeconomic disparities varied substantially between countries. National wealth and income inequality were associated with cross-country variation of disparities in lifetime use in few comparisons, such that among girls, the (negative) effect of family wealth was greatest in countries with unequally distributed income (OR = 0.86). Among boys, the (negative) effect of family wealth was greatest in low-income countries (OR = 1.00), and the (positive) effect of mothers' education was greatest in countries with high income inequality (OR = 1.11). Socioeconomic disparities in adolescent alcohol use vary across European countries. Broad country-level indicators can explain this variation only to a limited extent, but results point towards slightly greater socioeconomic disparities in drinking in countries of low national income and countries with a high income inequality. [Gomes de Matos E, Kraus L, Hannemann T-V, Soellner R, Piontek D. Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use. © 2017 Australasian Professional Society on Alcohol and other Drugs.

What fosters concern for inequality among American adolescents?

PubMed

Cech, Erin A

2017-01-01

Understanding cultural beliefs about social and economic inequality is vital to discerning the roadblocks and pathways to addressing that inequality. The foundation of concern for inequality is laid during adolescence, yet scholars understand little about the factors that influence whether and how adolescents come to express such concern. Arguing that structural and cultural contexts are just as consequential as whether adolescents themselves are members of disadvantaged groups, I draw on four theoretical perspectives to identify factors that influence adolescents' concern for addressing inequality: the underdog thesis, intergroup contact theory, the education enlightens thesis, and ideological buttressing. Using representative restricted-use Educational Longitudinal Survey data, I find that 12th-graders' beliefs are indeed influenced by more than their own demography: the diversity of their social milieu, the content of education in and out of the classroom, and ideological buttressing via political region and entertainment all influence whether they express concern for addressing inequality. These findings suggest extensions and amendments to the four theoretical perspectives and underscore the importance of studying structural and cultural factors that shape beliefs about inequality. The results also point to several interventions that may increase students' concern for inequality: involvement in civic-oriented extracurricular activities, more education in academic subjects that consider inequality, nurturing of cross-race friendships, and increased leisure reading. Copyright © 2016 Elsevier Inc. All rights reserved.

Relative Health Effects of Education, Socioeconomic Status and Domestic Gender Inequity in Sweden: A Cohort Study

PubMed Central

Phillips, Susan P.; Hammarström, Anne

2011-01-01

Introduction Limited existing research on gender inequities suggests that for men workplace atmosphere shapes wellbeing while women are less susceptible to socioeconomic or work status but vulnerable to home inequities. Methods Using the 2007 Northern Swedish Cohort (n = 773) we identified relative contributions of perceived gender inequities in relationships, financial strain, and education to self-reported health to determine whether controlling for sex, examining interactions between sex and other social variables, or sex-disaggregating data yielded most information about sex differences. Results and Discussion Men had lower education but also less financial strain, and experienced less gender inequity. Overall, low education and financial strain detracted from health. However, sex-disaggregated data showed this to be true for women, whereas for men only gender inequity at home affected health. In the relatively egalitarian Swedish environment where women more readily enter all work arenas and men often provide parenting, traditional primacy of the home environment (for women) and the work environment (for men) in shaping health is reversing such that perceived domestic gender inequity has a significant health impact on men, while for women only education and financial strain are contributory. These outcomes were identified only when data were sex-disaggregated. PMID:21747922

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992–2003

PubMed Central

Puigpinós, Rosa; Borrell, Carme; Antunes, José Leopoldo Ferreira; Azlor, Enric; Pasarín, M Isabel; Serral, Gemma; Pons-Vigués, Mariona; Rodríguez-Sanz, Maica; Fernández, Esteve

2009-01-01

Background The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. Methods The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992–1994, 1995–1997, 1998–2000, and 2001–2003). Results Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. Conclusion This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer. PMID:19166582

An equity dashboard to monitor vaccination coverage.

PubMed

Arsenault, Catherine; Harper, Sam; Nandi, Arijit; Rodríguez, José M Mendoza; Hansen, Peter M; Johri, Mira

2017-02-01

Equity monitoring is a priority for Gavi, the Vaccine Alliance, and for those implementing The 2030 agenda for sustainable development . For its new phase of operations, Gavi reassessed its approach to monitoring equity in vaccination coverage. To help inform this effort, we made a systematic analysis of inequalities in vaccination coverage across 45 Gavi-supported countries and compared results from different measurement approaches. Based on our findings, we formulated recommendations for Gavi's equity monitoring approach. The approach involved defining the vulnerable populations, choosing appropriate measures to quantify inequalities, and defining equity benchmarks that reflect the ambitions of the sustainable development agenda. In this article, we explain the rationale for the recommendations and for the development of an improved equity monitoring tool. Gavi's previous approach to measuring equity was the difference in vaccination coverage between a country's richest and poorest wealth quintiles. In addition to the wealth index, we recommend monitoring other dimensions of vulnerability (maternal education, place of residence, child sex and the multidimensional poverty index). For dimensions with multiple subgroups, measures of inequality that consider information on all subgroups should be used. We also recommend that both absolute and relative measures of inequality be tracked over time. Finally, we propose that equity benchmarks target complete elimination of inequalities. To facilitate equity monitoring, we recommend the use of a data display tool - the equity dashboard - to support decision-making in the sustainable development period. We highlight its key advantages using data from Côte d'Ivoire and Haiti.

An equity dashboard to monitor vaccination coverage

PubMed Central

Harper, Sam; Nandi, Arijit; Rodríguez, José M Mendoza; Hansen, Peter M; Johri, Mira

2017-01-01

Abstract Equity monitoring is a priority for Gavi, the Vaccine Alliance, and for those implementing The 2030 agenda for sustainable development. For its new phase of operations, Gavi reassessed its approach to monitoring equity in vaccination coverage. To help inform this effort, we made a systematic analysis of inequalities in vaccination coverage across 45 Gavi-supported countries and compared results from different measurement approaches. Based on our findings, we formulated recommendations for Gavi’s equity monitoring approach. The approach involved defining the vulnerable populations, choosing appropriate measures to quantify inequalities, and defining equity benchmarks that reflect the ambitions of the sustainable development agenda. In this article, we explain the rationale for the recommendations and for the development of an improved equity monitoring tool. Gavi’s previous approach to measuring equity was the difference in vaccination coverage between a country’s richest and poorest wealth quintiles. In addition to the wealth index, we recommend monitoring other dimensions of vulnerability (maternal education, place of residence, child sex and the multidimensional poverty index). For dimensions with multiple subgroups, measures of inequality that consider information on all subgroups should be used. We also recommend that both absolute and relative measures of inequality be tracked over time. Finally, we propose that equity benchmarks target complete elimination of inequalities. To facilitate equity monitoring, we recommend the use of a data display tool – the equity dashboard – to support decision-making in the sustainable development period. We highlight its key advantages using data from Côte d’Ivoire and Haiti. PMID:28250513

Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: Results from the World Health Survey

PubMed Central

2012-01-01

Background Noncommunicable diseases are an increasing health concern worldwide, but particularly in low- and middle-income countries. This study quantified and compared education- and wealth-based inequalities in the prevalence of five noncommunicable diseases (angina, arthritis, asthma, depression and diabetes) and comorbidity in low- and middle-income country groups. Methods Using 2002–04 World Health Survey data from 41 low- and middle-income countries, the prevalence estimates of angina, arthritis, asthma, depression, diabetes and comorbidity in adults aged 18 years or above are presented for wealth quintiles and five education levels, by sex and country income group. Symptom-based classification was used to determine angina, arthritis, asthma and depression rates, and diabetes diagnoses were self-reported. Socioeconomic inequalities according to wealth and education were measured absolutely, using the slope index of inequality, and relatively, using the relative index of inequality. Results Wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality. Conclusions Noncommunicable diseases are not necessarily diseases of the wealthy, and showed unequal distribution across socioeconomic groups in low- and middle-income country groups. Disaggregated research is warranted to assess the impact of individual noncommunicable diseases according to socioeconomic indicators. PMID:22726343

Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: results from the World Health Survey.

PubMed

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Mendis, Shanthi; Harper, Sam; Verdes, Emese; Kunst, Anton; Chatterji, Somnath

2012-06-22

Noncommunicable diseases are an increasing health concern worldwide, but particularly in low- and middle-income countries. This study quantified and compared education- and wealth-based inequalities in the prevalence of five noncommunicable diseases (angina, arthritis, asthma, depression and diabetes) and comorbidity in low- and middle-income country groups. Using 2002-04 World Health Survey data from 41 low- and middle-income countries, the prevalence estimates of angina, arthritis, asthma, depression, diabetes and comorbidity in adults aged 18 years or above are presented for wealth quintiles and five education levels, by sex and country income group. Symptom-based classification was used to determine angina, arthritis, asthma and depression rates, and diabetes diagnoses were self-reported. Socioeconomic inequalities according to wealth and education were measured absolutely, using the slope index of inequality, and relatively, using the relative index of inequality. Wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality. Noncommunicable diseases are not necessarily diseases of the wealthy, and showed unequal distribution across socioeconomic groups in low- and middle-income country groups. Disaggregated research is warranted to assess the impact of individual noncommunicable diseases according to socioeconomic indicators.

How Did the Increase in Economic Inequality between 1970 and 1990 Affect American Children's Educational Attainment?

ERIC Educational Resources Information Center

Mayer, Susan E.

This paper estimates the effect of the growth in income inequality on mean educational attainment and on the disparity in educational attainment between rich and poor children. The effect of income inequality that is due to the nonlinear effect of a family's own income is separated from the effect due to interpersonal interactions. Data from the…

Constructing Educational Inequality: An Assessment of Research on School Processes. Social Research and Educational Studies Series: 15.

ERIC Educational Resources Information Center

Foster, Peter; And Others

This book examines much of the large body of research on educational inequality in Britain since the Second World War, focusing on studies concerned with inequalities in the internal organization and functioning of the schools. A social constructionist approach to the study of social problems as a way of providing a reflexive perspective on the…

Distinguishing the race-specific effects of income inequality and mortality in U.S. metropolitan areas.

PubMed

Nuru-Jeter, Amani M; Williams, T; LaVeist, Thomas A

2014-01-01

In the United States, the association between income inequality and mortality has been fairly consistent. However, few studies have explicitly examined the impact of race. Studies that have either stratified outcomes by race or conducted analyses within race-specific groups suggest that the income inequality/mortality relation may differ for blacks and whites. The factors explaining the association may also differ for the two groups. Multivariate ordinary least squares regression analysis was used to examine associations between study variables. We used three measures of income inequality to examine the association between income inequality and age-adjusted all-cause mortality among blacks and whites separately. We also examined the role of racial residential segregation and concentrated poverty in explaining associations among groups. Metropolitan areas were included if they had a population of at least 100,000 and were at least 10 percent black. There was a positive income inequality/mortality association among blacks and an inverse association among whites. Racial residential segregation completely attenuated the income inequality/mortality relationship for blacks, but was not significant among whites. Concentrated poverty was a significant predictor of mortality rates in both groups but did not confound associations. The implications of these findings and directions for future research are discussed.

Socioeconomic inequalities in dental services utilisation in a Norwegian county: the third Nord-Trondelag Health Survey.

PubMed

Vikum, Eirik; Krokstad, Steinar; Holst, Dorthe; Westin, Steinar

2012-11-01

To assess the level of socioeconomic inequity in dental care utilisation in Norway and enable comparison with recent international comparative studies. We studied dental care utilisation among 17,136 men and 21,414 women in the third Nord-Trøndelag Health Survey (2006-08). Respondents aged 20 years and above were included in the study, and analyses were also performed within subgroups of age and gender (20-39, 40-59, and ≥60 years). Income-related horizontal inequity was estimated by means of concentration indices. Education-related inequity was estimated as relative risks. We found consistent pro-rich income inequity among men and women of all ages. The level of income inequity was highest among men and women ≥60 years, and in this group the income gradient was steepest between the poorest and the middle quintiles. Pro-educated inequity was found exclusively among men and women ≥60 years. General attendance was high (77%). The overall level of income-related inequity in dental services utilisation was low compared to other European countries as reported in two recent international studies of socioeconomic inequalities in dental care utilisation. Pro-rich and pro-educated inequity is a public health challenge mainly in the older part of the population.

Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: why we should measure them all.

PubMed

Asada, Yukiko; Whipp, Alyce; Kindig, David; Billard, Beverly; Rudolph, Barbara

2014-06-13

Regular reporting of health inequalities is essential to monitoring progress of efforts to reduce health inequalities. While reporting of population health became increasingly common, reporting of a subpopulation group breakdown of each indicator of the health of the population is rarely a standard practice. This study reports education-, sex-, and race-related inequalities in four health outcomes in each of the selected 93 counties in the United States in a systematic and comparable manner. This study is a cross-sectional analysis of large, publicly available data, 2008, 2009, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) Selected Metropolitan/Micropolitan Area Risk Trends (SMART) and 2008, 2009, and 2010 United States Birth Records from the National Vital Statistics System. The study population is American adults older than 25 years of age residing in the selected 93 counties, representing about 30% of the US population, roughly equally covering all geographic regions of the country. Main outcome measures are: (1) Attribute (group characteristic)-specific inequality: education-, sex-, or race-specific inequality in each of the four health outcomes (poor or fair health, poor physical health days, poor mental health days, and low birthweight) in each county; (2) Overall inequality: the average of these three attribute-specific inequalities for each health outcome in each county; and (3) Summary inequality in total morbidity: the weighted average of the overall inequalities across the four health outcomes in each county. The range of inequality across the counties differed considerably by health outcome; inequality in poor or fair health had the widest range and the highest median among inequalities in all health outcomes. In more than 70% of the counties, education-specific inequality was the largest in all health outcomes except for low birthweight. It is feasible to extend population health reporting to include reporting of a subpopulation group breakdown of each indicator of the health of the population at a small jurisdictional level using publicly available data. No single group characteristic or health outcome represents the whole picture of health inequalities in a population. Examining multiple group characteristics and outcomes in a comparable manner is essential in reporting health inequalities.

Globalization, Educational Targeting, and Stable Inequalities: A Comparative Analysis of Argentina, Brazil, and Chile

NASA Astrophysics Data System (ADS)

Rambla, Xavier

2006-05-01

The present study analyzes educational targeting in Argentina, Brazil and Chile from a sociological point of view. It shows that a `logic of induction' has become the vehicle for anti-poverty education strategies meant to help targeted groups improve on their own. The analysis explores the influence of the global educational agenda, the empirical connection between the logic of induction and the mechanism of emulation, and the territorial aspects of educational inequalities. Emulation plays a main role inasmuch as the logic of induction leads targeted groups to compare their adverse situation with more privileged groups, which actually legitimizes inequalities. A brief statistical summary completes the study, showing that educational inequality has remained unchanged as far as urban-rural ratios (in Brazil and Chile) and regional disparities (in all three countries) are concerned.

Teachers Interpreting Data for Instructional Decisions: Where Does Equity Come In?

ERIC Educational Resources Information Center

Garner, Brette; Thorne, Jennifer Kahn; Horn, Ilana Seidel

2017-01-01

Purpose: Though test-based accountability policies seek to redress educational inequities, their underlying theories of action treat inequality as a technical problem rather than a political one: data point educators toward ameliorative actions without forcing them to confront systemic inequities that contribute to achievement disparities. To…

Education and Social Change in China: Inequality in a Market Economy

ERIC Educational Resources Information Center

Postiglione, Gerard A., Ed.

2006-01-01

Market reform, financial decentralization, and economic globalization have greatly accentuated China's social and regional inequalities. Education is expected to address these inequalities in a context of rapid social change, including the rise of an urban middle class, changed status of women, resurgence of ethnic identities, growing rural to…

School Inequality and the Welfare State.

ERIC Educational Resources Information Center

Owen, John D.

This book begins with an examination of school inequality in the United States. The discussion focuses successively on the issues of: the paradox of unequal schools in a welfare state, the distribution of educational resources in American cities: some new empirical evidence, inequalities in the allocation of educational resources among cities and…

Cohort Change and Racial Differences in Educational and Income Mobility

ERIC Educational Resources Information Center

Bloome, Deirdre; Western, Bruce

2011-01-01

Policy reforms and rising income inequality transformed educational and economic opportunities for Americans approaching midlife in the 1990s. Rising income inequality may have reduced mobility, as income gaps increased between rich and poor children. Against the effects of rising inequality, Civil Rights reforms may have increased mobility, as…

The Political Economy of Education and Inequality: Reflections on Piketty

ERIC Educational Resources Information Center

Klees, Steven J.

2017-01-01

Piketty's "Capitalism in the twenty-first century" provides a superb, detailed historical analysis of the evolution of income and wealth inequality. Piketty demonstrates vast and increasing inequality that he argues might possibly be tempered in the future by economic growth and educational expansion supplemented by government…

Segregation and the Underrepresentation of Blacks and Hispanics in Gifted Education: Social Inequality and Deficit Paradigms

ERIC Educational Resources Information Center

Ford, Donna Y.

2014-01-01

This article examines the underrepresentation of African American and Hispanic students in gifted education, proposing that social inequality, deficit thinking, and microaggressions contribute to the inequitable segregated programs. Underrepresentation trends are presented, along with methods for calculating underrepresentation and inequity.…

A Method of Measuring Inequality within a Selection Process

ERIC Educational Resources Information Center

Bulle, Nathalie

2016-01-01

To explain the inequalities in access to a discrete good G across two populations, or across time in a single national context, it is necessary to distinguish, for each population or period of time, the effect of the diffusion of G from that of unequal outcomes of underlying micro-social processes. The inequality of outcomes of these micro-social…

Occupations and the Structure of Wage Inequality in the United States, 1980s to 2000s

ERIC Educational Resources Information Center

Mouw, Ted; Kalleberg, Arne L.

2010-01-01

Occupations are central to the stratification systems of industrial countries, but they have played little role in empirical attempts to explain the well-documented increase in wage inequality that occurred in the United States in the 1980s and 1990s. We address this deficiency by assessing occupation-level effects on wage inequality using data…

Two Aspects of the Rural-Urban Divide and Educational Stratification in China: A Trajectory Analysis.

PubMed

Hao, Lingxin; Hu, Alfred; Lo, Jamie

2014-08-01

Contextualized in China's social change of the past half-century, this paper develops the notion of dichotomous inequality to conceptualize the two aspects of China's rural-urban divide in educational inequality-the household registration system ( hukou ) assigns people to a top-bottom hierarchy, and the rural-urban schooling system institutionalizes unequal resource distribution and diverse school mission. Based on this conceptualization, we formulate a Chinese version of the maximally maintained inequality (MMI) hypothesis. We capitalize on individual educational history data from the China General Social Survey (CGSS) 2008 and conduct a trajectory analysis using the generalized mixture modeling to estimate the differential effects of the two aspects of rural-urban divide on educational inequality in China. Findings indicate that (1) the sorting mechanism of the rural hukou places rural- hukou people in the very bottom of educational stratification, (2) the penalty of attending rural pre-tertiary school increases with educational stages, and (3) there is a cumulative disadvantage of rural hukou and rural school. Overall, our findings attest to the Chinese-version MMI and the behind principle of inequality reproduction.

On measuring and decomposing inequality of opportunity in access to health services among Tunisian children: a new approach for public policy.

PubMed

Saidi, Anis; Hamdaoui, Mekki

2017-10-25

The early years in children's life are the key to physical, cognitive-language, and, socio-emotional skills development. So, it is of paramount importance in this period to be interested in different indicators that would influence the child's health. This paper measures inequality of opportunities among Tunisian children concerning access to nutritional and healthy services using Human Opportunity-Index and Shapely decomposition methods. Many disparities between regions have been detected since 1982 until 2012. Tunisian children face unequal opportunities to develop in terms of health, nutrition, cognitive, social, and emotional development. Likewise, we found that, parents' education, wealth, age of household head and geographic factors as key factors determining child development outcomes. Our findings suggested that childhood unequal opportunities in Tunisia are explained by pension funds deficiency and structural problem in the labor market. The results of a health care intervention on human participants "retrospectively registered".

Attitudes toward rape and victims of rape: a test of the feminist theory in Ghana.

PubMed

Boakye, Kofi E

2009-10-01

This study explores the usefulness of the feminist theory in explaining attitudes toward rape and victims of rape in Ghana. The feminist theory of rape posits, inter alia, that patriarchy and gender inequality are major factors in the aetiology of rape and attitudes toward rape and that underlying patriarchy and gender inequality are gender stereotypes and false beliefs (myths) about rape, rapists, and victims of rape. Thus, the theory suggests a relationship between rape myths and less favorable attitudes toward rape and victims of rape. Results from a survey conducted in Ghana show some support for the feminist theory of rape: There is evidence of rape myth acceptance in Ghana; gender is significant in predicting levels of rape myth acceptance; and finally, education or profession and age, but not religion, are associated with levels of rape myth acceptance in a predictable way.

Assortative Mating and the Reversal of Gender Inequality in Education in Europe: An Agent-Based Model

PubMed Central

Grow, André; Van Bavel, Jan

2015-01-01

While men have always received more education than women in the past, this gender imbalance in education has turned around in large parts of the world. In many countries, women now excel men in terms of participation and success in higher education. This implies that, for the first time in history, there are more highly educated women than men reaching the reproductive ages and looking for a partner. We develop an agent-based computational model that explicates the mechanisms that may have linked the reversal of gender inequality in education with observed changes in educational assortative mating. Our model builds on the notion that individuals search for spouses in a marriage market and evaluate potential candidates based on preferences. Based on insights from earlier research, we assume that men and women prefer partners with similar educational attainment and high earnings prospects, that women tend to prefer men who are somewhat older than themselves, and that men prefer women who are in their mid-twenties. We also incorporate the insight that the educational system structures meeting opportunities on the marriage market. We assess the explanatory power of our model with systematic computational experiments, in which we simulate marriage market dynamics in 12 European countries among individuals born between 1921 and 2012. In these experiments, we make use of realistic agent populations in terms of educational attainment and earnings prospects and validate model outcomes with data from the European Social Survey. We demonstrate that the observed changes in educational assortative mating can be explained without any change in male or female preferences. We argue that our model provides a useful computational laboratory to explore and quantify the implications of scenarios for the future. PMID:26039151

Parents' education and child body weight in France: The trajectory of the gradient in the early years.

PubMed

Apouey, Bénédicte H; Geoffard, Pierre-Yves

2016-03-01

This paper explores the relationship between parental education and offspring body weight in France. Using two large datasets spanning the 1991-2010 period, we examine the existence of inequalities in maternal and paternal education and reported child body weight measures, as well as their evolution across childhood. Our empirical specification is flexible and allows this evolution to be non-monotonic. Significant inequalities are observed for both parents' education--maternal (respectively paternal) high education is associated with a 7.20 (resp. 7.10) percentage points decrease in the probability that the child is reported to be overweight or obese, on average for children of all ages. The gradient with respect to parents' education follows an inverted U-shape across childhood, meaning that the association between parental education and child body weight widens from birth to age 8, and narrows afterward. Specifically, maternal high education is correlated with a 5.30 percentage points decrease in the probability that the child is reported to be overweight or obese at age 2, but a 9.62 percentage points decrease at age 8, and a 1.25 percentage point decrease at age 17. The figures for paternal high education are respectively 5.87, 9.11, and 4.52. This pattern seems robust, since it is found in the two datasets, when alternative variables for parental education and reported child body weight are employed, and when controls for potential confounding factors are included. The findings for the trajectory of the income gradient corroborate those of the education gradient. The results may be explained by an equalization in actual body weight across socioeconomic groups during youth, or by changes in reporting styles of height and weight. Copyright © 2015 Elsevier B.V. All rights reserved.

Assortative mating and the reversal of gender inequality in education in europe: an agent-based model.

PubMed

Grow, André; Van Bavel, Jan

2015-01-01

While men have always received more education than women in the past, this gender imbalance in education has turned around in large parts of the world. In many countries, women now excel men in terms of participation and success in higher education. This implies that, for the first time in history, there are more highly educated women than men reaching the reproductive ages and looking for a partner. We develop an agent-based computational model that explicates the mechanisms that may have linked the reversal of gender inequality in education with observed changes in educational assortative mating. Our model builds on the notion that individuals search for spouses in a marriage market and evaluate potential candidates based on preferences. Based on insights from earlier research, we assume that men and women prefer partners with similar educational attainment and high earnings prospects, that women tend to prefer men who are somewhat older than themselves, and that men prefer women who are in their mid-twenties. We also incorporate the insight that the educational system structures meeting opportunities on the marriage market. We assess the explanatory power of our model with systematic computational experiments, in which we simulate marriage market dynamics in 12 European countries among individuals born between 1921 and 2012. In these experiments, we make use of realistic agent populations in terms of educational attainment and earnings prospects and validate model outcomes with data from the European Social Survey. We demonstrate that the observed changes in educational assortative mating can be explained without any change in male or female preferences. We argue that our model provides a useful computational laboratory to explore and quantify the implications of scenarios for the future.

Smoking in school-aged adolescents: design of a social network survey in six European countries.

PubMed

Lorant, Vincent; Soto, Victoria Eugenia; Alves, Joana; Federico, Bruno; Kinnunen, Jaana; Kuipers, Mirte; Moor, Irene; Perelman, Julian; Richter, Matthias; Rimpelä, Arja; Robert, Pierre-Olivier; Roscillo, Gaetano; Kunst, Anton

2015-03-21

In Western countries, smoking accounts for a large share of socio-economic inequalities in health. As smoking initiation occurs around the age of 13, it is likely that school context and social networks at school play a role in the origin of such inequalities. So far, there has been little generic explanation of how social ties at school contribute to socio-economic inequalities in smoking. The SILNE (Smoking Inequalities - Learning from Natural Experiments) survey was designed to test the hypothesis that a combination of peer effect, homophilous social ties, and school context may explain how smoking inequalities are magnified at school - a theory known as network-induced inequality. In this paper, the survey theory and design are presented. The social network survey was carried out in 2013 in six medium-sized European cities with average incomes similar to the national average: Namur (Belgium), Tampere (Finland), Hannover (Germany), Latina (Italy), Amersfoort (The Netherlands), and Coimbra (Portugal). In each city, 6 to 8 schools were selected in a stratified sampling procedure. In each school, two grades in secondary education, corresponding to 14-16-year-olds, were selected. All adolescents in these two grades were invited to participate in the survey. Social ties were reported using the roster approach, in which each adolescent had to nominate up to 5 friends from a directory. The survey collected information from 11,015 adolescents in 50 schools, out of a total of 13,870 registered adolescents, yielding a participation rate of 79%. The SILNE survey yielded 57,094 social ties, 86.7% of which referred to friends who also participated in the survey. The SILNE survey was designed to measure the association between adolescents' social ties at school, their socio-economic background, and their smoking behaviour. Two difficulties were encountered, however: legal privacy constraints made it impossible to apply the same parental consent procedure in all countries, leading to somewhat lower participation rates in two cities: Hannover and Latina. It was also difficult to match the 6 cities in terms of both age and type of education. The SILNE survey provided a comparable database for the study of smoking inequalities across European cities from a social network perspective.

Differential health reporting by education level and its impact on the measurement of health inequalities among older Europeans

PubMed Central

Bago d’Uva, Teresa; O’Donnell, Owen; van Doorslaer, Eddy

2008-01-01

Background This study aims to establish whether health reporting differs by education level and, if so, to determine the extent to which this biases the measurement of health inequalities among older Europeans. Methods Data are from the Survey of Health, Ageing and Retirement in Europe (SHARE) covering eight countries. Differential reporting of health by education is identified from ratings of anchoring vignettes that describe fixed health states. Ratings of own health in six domains (mobility, pain, sleep, breathing, emotional health and cognition) are corrected for differences in reporting using an extended ordered probit model. For each country and health domain, we compare the corrected with the uncorrected age–sex standardized high-to-low education rate ratio for the absence of a health problem. Results Before correction for reporting differences across the 48 combinations of country by health domain, there was no inequality in health by education (P > 0.05) in 32 of 48 cases. However, there were reporting differences by education (P < 0.05) in 29 out of 48 cases. In general, higher educated older Europeans are more likely to rate a given health state negatively (except for Spain and Sweden). Correcting for these differences generally increases health inequalities (except for Spain and Sweden) and results in the emergence of inequalities in 18 cases (P < 0.05), which may be considered ‘statistically significant’. The greatest impact is in Belgium, Germany and The Netherlands, where inequalities (P < 0.05) appear only after adjustment in four of the six health domains. Conclusions These results emphasize the need to account for differences in the reporting of health. Measured health inequalities by education are often underestimated, and even go undetected, if no account is taken of these reporting differences. PMID:18676985

Principles of Lifeworld Led Public Health Practice in the UK and Sweden: Reducing Health Inequalities.

PubMed

Hemingway, Ann; Norton, Liz; Aarts, Clara

2015-01-01

The purpose of this paper is to consider the role of the lifeworld perspective in reducing inequalities in health and we explain how the public health practitioner can use this perspective to address public health issues with individuals and groups. We offer ideas for public health actions that are based on and deal with the lifeworld context of individual people or families. Each of the dimensions of the lifeworld temporality, spatiality, intersubjectivity, embodiment and mood are outlined and their significance explained in relation to health inequalities. Suggestions for action to reduce health inequalities are made and overall principles of lifeworld led public health practice are proposed by way of conclusion. The principles comprise understanding the community members' lifeworld view, understanding their view of their potential, offering resources and facilitating empowerment, and sharing lifeworld case studies and lobbying to influence local and national policy in relation to both the individual and communities.

Equitable health services for the young? A decomposition of income-related inequalities in young adults' utilization of health care in Northern Sweden.

PubMed

Mosquera, Paola A; Waenerlund, Anna-Karin; Goicolea, Isabel; Gustafsson, Per E

2017-01-18

Despite the goal of the Swedish health system to offer health care according to the principle of horizontal equity, little is known about the equality in access to health care use among young people. To explore this issue, the present study aimed i) to assess horizontal inequity in health care utilization among young people in Northern Sweden; and ii) to explore the contribution of different factors to explain the observed inequalities. Participants (N = 3016 youths aged 16-25 years) came from the "Health on Equal terms" survey conducted in 2014 in the four northernmost counties in Sweden. Concentration indices (C) and horizontal inequity indices (HI) were calculated to measure inequalities in the utilization of two health care services (general practitioners (GP) and youth clinics). The HI was calculated based on health care utilization and variables representing socioeconomic status (household income), health care needs factors and non-need factors affecting health care use. A decomposition analysis was carried out to explain the income-related inequalities. Results showed a significant positive income-related inequality for youth clinic utilization in women (C = 0.166) and total sample (C = 0.097), indicating that services were concentrated among the better-off. In contrast, general practitioner visits showed inequality pointing toward a higher utilization among less affluent individuals; significant in women (C = -0.079), men (C = -0.101) and pooled sample (C = -0.097). After taking health care needs into consideration, the utilization of youth clinics remained significantly pro-rich in women (HI = 0.121) and total sample (HI = 0.099); and consistently pro-poor for the GP visits in the pooled sample (HI = -0.058). The decomposition analyses suggest that socioeconomic inequalities explain a considerable portion of the pro-rich utilization of youth clinics services among young women. The corresponding analyses for GP visits showed that need factors and socioeconomic conditions accounted for the pro-poor concentration of GP visits. The distribution of GP visits among young people in Northern Sweden slightly favored the low-income group, and thus seems to meet the premises of horizontal equity. In contrast, the findings suggest substantial pro-rich horizontal inequity in the utilization of youth clinics among young women, which are largely rooted in socioeconomic inequalities.

Decomposing socio-economic inequality in colorectal cancer screening uptake in England.

PubMed

Solmi, Francesca; Von Wagner, Christian; Kobayashi, Lindsay C; Raine, Rosalind; Wardle, Jane; Morris, Stephen

2015-06-01

Colorectal cancer (CRC) is the second largest cause of cancer death in the UK. Since 2010, CRC screening based on Faecal Occult Blood testing has been offered by the NHS in England biennially to all persons age 60-69 years. Several studies have demonstrated a gradient in uptake using area-level markers of socio-economic status (SES), but few have examined the individual-level contributors to the gradient. We aimed to quantify the extent of SES inequality in CRC screening uptake in England using individual-level data, and to identify individual factors associated with this inequality. We used data from 1833 participants (aged 61-69) in Wave 5 (collected in years 2010/11) of the English Longitudinal Study of Ageing (ELSA) eligible for having been sent at least one CRC screening invitation. Uptake was defined by self-report of ever having been screened as part of the National Screening Programme. We assessed socio-economic inequality using the corrected concentration index of uptake against SES rank, which was derived by regressing a range of SES markers against net non-pension household wealth. Other demographic and health-related variables were included in the analysis. Factors associated with inequality were measured using concentration index decomposition. There was a significant pro-rich gradient in screening uptake (concentration index: 0.16, 95% CI:0.11-0.22), mostly explained within our model by differences in non-pension wealth (38.7%), partner screening status (15.9%), sickness/disability (13.5%), and health literacy (8.5%). Interventions aimed at reducing inequalities in CRC screening uptake should focus on improving acceptability of screening in populations with low levels of education and literacy barriers. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Application of a simple methodological approach to analyze health inequalities: the case of infant mortality in Chile].

PubMed

Frenz, Patricia; González, Claudia

2010-09-01

the infant mortality gradient by maternal education is a good indicator of the health impact of the social inequalities that prevail in Chile. to propose a systematic method of analysis, using simple epidemiological measures, for the comparison of differential health risks between social groups that change over time. data and statistics on births and infant deaths, obtained from the Ministry of Health, were used. Five strata of maternal schooling were defined and various measures were calculated to compare infant mortality, according to maternal education in the periods 1998-2001 and 2001-2003. of particular interest is the distinction between a measure of effect, Relative Risk (RR), which indicates the size of the gap between socioeconomic extremes and the etiological strength of low maternal schooling on infant mortality, and a measure of global impact, the Population Attributable Risk (PAR%), which takes into account the whole socioeconomic distribution and permits comparisons over time independently of the variability in the proportions of the different social strata. The comparison of these measures in the two periods studied, reveals an increase in the infant mortality gap between maternal educational extremes measured by the RR, but a stabilization in the population impact of low maternal schooling. these results can be explained by a decline in the proportion of mothers in the lowest educational level and an increase in the proportion in the highest group.

Effects of the 1994 Tax Reform on Intraprovincial Inequalities in Financing Basic Education

ERIC Educational Resources Information Center

Lin, Tingjin

2009-01-01

This study explores the influence of the 1994 tax reform on intraprovincial inequality in financing basic education. The empirical analysis finds that the reform has decreased inequality in general, suggesting that the center may attain its policy goal through centralizing its relative fiscal capability and increasing the intergovernmental…

Income Inequality and the Education Divide.

ERIC Educational Resources Information Center

Welch, Mary A., Ed.

1998-01-01

The economics of the decision to go to college or obtain technical training is discussed in this booklet. To stay competitive in the job market requires constant educational updating. The following questions are discussed: (1) how income inequality is measured; (2) how income is distributed in the United States; (3) why income inequality is…

Decomposing Inequalities in Performance Scores: The Role of Student Background, Peer Effects and School Characteristics

ERIC Educational Resources Information Center

Mostafa, Tarek

2010-01-01

This paper analyses the mechanisms of stratification and inequalities in educational achievements. The main objective is to determine how stratification leads to unequal educational outcomes and how inequalities are channelled through student characteristics, school characteristics and peer effects. This analysis is undertaken in five countries…

Ethnicity and Education in China and Vietnam: Discursive Formations of Inequality

ERIC Educational Resources Information Center

DeJaeghere, Joan; Wu, Xinyi; Vu, Lisa

2015-01-01

This article aims to understand how ethnicity is discursively framed in national policies in China and Vietnam and argues that policy discourses affect how the "problem" of ethnicity and educational inequalities is framed and how these inequalities can be addressed. The analysis shows how both Marxist and market-economy governing…

Degrees of Inequality: Culture, Class, and Gender in American Higher Education

ERIC Educational Resources Information Center

Mullen, Ann L.

2010-01-01

"Degrees of Inequality" reveals the powerful patterns of social inequality in American higher education by analyzing how the social background of students shapes nearly every facet of the college experience. Even as the most prestigious institutions claim to open their doors to students from diverse backgrounds, class disparities remain.…

Colorism in the Classroom: How Skin Tone Stratifies African American and Latina/o Students

ERIC Educational Resources Information Center

Hunter, Margaret

2016-01-01

Although racial inequality is frequently studied in education, skin tone stratification has received less attention from educational researchers. Inequality by skin tone, also known as "colorism", contributes to larger patterns of racial inequality for African Americans and Latina/os. Discrimination by skin tone affects many dimensions…

Capital, Inequality and Education in Conflict-Affected Contexts

ERIC Educational Resources Information Center

Novelli, Mario

2016-01-01

Piketty's "Capital in the Twenty-First Century" has brought the issue of inequality to the centre of political debate. This article explores contemporary research on the relationship between education and inequality in conflict-affected contexts with a view to seeing how Piketty's work speaks to these issues as a field of research and…

Evolution of educational inequalities in site-specific cancer mortality among Belgian men between the 1990s and 2000s using a "fundamental cause" perspective.

PubMed

Vanthomme, Katrien; Vandenheede, Hadewijch; Hagedoorn, Paulien; Gadeyne, Sylvie

2017-07-05

According to the "fundamental cause" theory, emerging knowledge on health-enhancing behaviours and technologies results in health disparities. This study aims to assess (trends in) educational inequalities in site-specific cancer mortality in Belgian men in the 1990s and the 2000s using this framework. Data were derived from record linkage between the Belgian censuses of 1991 and 2001 and register data on mortality. The study population comprised all Belgian men aged 50-79 years during follow-up. Both absolute and relative inequality measures have been calculated. Despite an overall downward trend in cancer mortality, educational differences are observed for the majority of cancer sites in the 2000s. Generally, inequalities are largest for mortality from preventable cancers. Trends over time in inequalities are rather stable compared with the 1990s. Educational differences in site-specific cancer mortality persist in the 2000s in Belgium, mainly for cancers related to behavioural change and medical interventions. Policy efforts focussing on behavioural change and healthcare utilization remain crucial in order to tackle these increasing inequalities.

Children’s Perceptions of Social Resource Inequality

PubMed Central

Elenbaas, Laura; Killen, Melanie

2016-01-01

Children’s perceptions of social resource inequalities were investigated by measuring spontaneous explanations for race-based disparities in access to societal resources. Fifth graders (N = 139, M = 11.14 years, SD = .61 years) viewed animated vignettes depicting hypothetical resource inequalities between institutions serving children of African-American and European-American background. Children frequently explained disparities in terms of institutions’ differing financial resources, revealing awareness that economic inequalities often underlie groups’ differential access to societal resources. Further, children attributed inequalities to preferential treatment more often when they witnessed African-Americans at a disadvantage than when they witnessed European-Americans at a disadvantage, demonstrating awareness that racial minority groups are more likely to experience restricted access to resources. Finally, children who reasoned about preferential treatment judged inequality, and actions that perpetuated inequality, more negatively than children who attributed inequalities to institutions’ differing needs, revealing a link between awareness of discrimination and rejection of social inequalities. PMID:28717258

Exploring educational disparities in risk of preterm delivery: a comparative study of 12 European birth cohorts.

PubMed

Poulsen, Gry; Strandberg-Larsen, Katrine; Mortensen, Laust; Barros, Henrique; Cordier, Sylvaine; Correia, Sofia; Danileviciute, Asta; van Eijsden, Manon; Fernández-Somoano, Ana; Gehring, Ulrike; Grazuleviciene, Regina; Hafkamp-de Groen, Esther; Henriksen, Tine Brink; Jensen, Morten Søndergaard; Larrañaga, Isabel; Magnus, Per; Pickett, Kate; Raat, Hein; Richiardi, Lorenzo; Rouget, Florence; Rusconi, Franca; Stoltenberg, Camilla; Uphoff, Eleonora P; Vrijkotte, Tanja G M; Wijga, Alet H; Vrijheid, Martine; Osler, Merete; Andersen, Anne-Marie Nybo

2015-05-01

An association between education and preterm delivery has been observed in populations across Europe, but differences in methodology limit comparability. We performed a direct cross-cohort comparison of educational disparities in preterm delivery based on individual-level birth cohort data. The study included data from 12 European cohorts from Denmark, England, France, Lithuania, the Netherlands, Norway, Italy, Portugal, and Spain. The cohorts included between 2434 and 99 655 pregnancies. The association between maternal education and preterm delivery (22-36 completed weeks of gestation) was reported as risk ratios, risk differences, and slope indexes of inequality with 95% confidence intervals (CIs). Singleton preterm live delivery proportion varied between 3.7% and 7.5%. There were large variations between the cohorts in the distribution of education and maternal characteristics. Nevertheless, there were similar educational differences in risk of preterm delivery in 8 of the 12 cohorts with slope index of inequality varying between 2.2 [95% CI 1.1, 3.3] and 4.0 [95% CI 1.4, 6.6] excess preterm deliveries per 100 singleton deliveries among the educationally most disadvantaged, and risk ratio between the lowest and highest education category varying from 1.4 [95% CI 1.1, 1.8] to 1.9 [95% CI 1.2, 3.1]. No associations were found in the last four cohorts. Educational disparities in preterm delivery were found all over Europe. Despite differences in the distributions of education and preterm delivery, the results were remarkably similar across the cohorts. For those few cohorts that did not follow the pattern, study and country characteristics did not explain the differences. © 2015 John Wiley & Sons Ltd.

Educational class inequalities in the incidence of coronary heart disease in Europe.

PubMed

Veronesi, Giovanni; Ferrario, Marco M; Kuulasmaa, Kari; Bobak, Martin; Chambless, Lloyd E; Salomaa, Veikko; Soderberg, Stefan; Pajak, Andrzej; Jørgensen, Torben; Amouyel, Philippe; Arveiler, Dominique; Drygas, Wojciech; Ferrieres, Jean; Giampaoli, Simona; Kee, Frank; Iacoviello, Licia; Malyutina, Sofia; Peters, Annette; Tamosiunas, Abdonas; Tunstall-Pedoe, Hugh; Cesana, Giancarlo

2016-06-15

To estimate the burden of social inequalities in coronary heart disease (CHD) and to identify their major determinants in 15 European populations. The MORGAM (MOnica Risk, Genetics, Archiving and Monograph) study comprised 49 cohorts of middle-aged European adults free of CHD (110 928 individuals) recruited mostly in the mid-1980s and 1990s, with comparable assessment of baseline risk and follow-up procedures. We derived three educational classes accounting for birth cohorts and used regression-based inequality measures of absolute differences in CHD rates and HRs (ie, Relative Index of Inequality, RII) for the least versus the most educated individuals. N=6522 first CHD events occurred during a median follow-up of 12 years. Educational class inequalities accounted for 343 and 170 additional CHD events per 100 000 person-years in the least educated men and women compared with the most educated, respectively. These figures corresponded to 48% and 71% of the average event rates in each gender group. Inequalities in CHD mortality were mainly driven by incidence in the Nordic countries, Scotland and Lithuania, and by 28-day case-fatality in the remaining central/South European populations. The pooled RIIs were 1.6 (95% CI 1.4 to 1.8) in men and 2.0 (1.7 to 2.4) in women, consistently across population. Risk factors accounted for a third of inequalities in CHD incidence; smoking was the major mediator in men, and High-Density-Lipoprotein (HDL) cholesterol in women. Social inequalities in CHD are still widespread in Europe. Since the major determinants of inequalities followed geographical and gender-specific patterns, European-level interventions should be tailored across different European regions. 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/

[Changing social disparities and mortality in France (1968-1996): cause of death analysis by educational level].

PubMed

Menvielle, G; Chastang, J-F; Luce, D; Leclerc, A

2007-04-01

Little information is available on temporal trend in socioeconomic inequalities in cause of death mortality in France. The aim of this paper was to study educational differences in mortality in France by cause of death and their temporal trend. We used a representative sample of 1% of the French population and compared four periods (1968-1974, 1975-1981, 1982-1988, 1990-1996). Causes of death were obtained by direct linkage with the French national death registry. Education was measured at the beginning of each period, and educational disparities in mortality were studied among men and women aged 30-64 at the beginning of each period. Analyses were conducted for all deaths and for the following causes of death: all cancers, lung cancer (among men), upper aerodigestive tract cancers (among men), breast cancer (among women), colorectal cancer, other cancers, cardiovascular diseases, ischaemic heart diseases, cerebrovascular diseases, other cardiovascular diseases, external causes, other causes of death. Socioeconomic inequalities were quantified with relative risks and relative indices of inequality. The relative indices of inequality measures socioeconomic inequalities across the population and can be interpreted as the ratio of mortality rates of those with the lowest to those with the highest socioeconomic status. Analyses showed an increase in educational differences in all cause mortality among men (the relative indices of inequality increased from 1.96 to 2.77 from the first to the last period) and among women (the relative indices of inequality increased from 1.87 to 2.53). Socioeconomic inequalities increased for all cause of death studied among women, and for cancer and cardiovascular diseases among men. The contribution of cancer mortality to difference in overall mortality between the lowest and the highest levels of education increased strongly over the whole study period, especially among women. This study shows that large socioeconomic inequalities in mortality are observed in France, and that they increase over time among men and women.

Measuring Education Inequality: Gini Coefficients of Education. Policy Research Working Paper.

ERIC Educational Resources Information Center

Thomas, Vinod; Wang, Yan; Fan, Xibo

This paper aims at developing a measure for educational inequality for a large number of countries over time, using the concept of education Gini index based on school attainment data of the concerned population (or labor force). Education Gini could be used as one of the indicators of welfare, complementing average educational attainment, health…

Fair Access to Higher Education: Analysis of a Targeted Incentive Educational Policy

ERIC Educational Resources Information Center

Le Chapelain, Charlotte

2007-01-01

Social inequality with regard to education seems to be mainly the result of two factors: the reduced success of certain socio-economical categories within the education system and distinct educational requirements once the compulsory education period is over. In this article, we shall focus on the inequality stemming from the choices and personal…

Socioeconomic inequalities and body mass index in Västerbotten County, Sweden: a longitudinal study of life course influences over two decades.

PubMed

Padyab, Mojgan; Norberg, Margareta

2014-05-07

Life course socioeconomic inequalities in heart disease, stroke and all-cause mortality are well studied in Sweden. However, few studies have sought to explain the mechanism for such associations mainly due to lack of longitudinal data with multiple measures of socioeconomic status (SES) across the life course. Given the population health concern about how socioeconomic inequality is related to poorer health, we aim to tackle obesity as one of the prime suspects that could explain the association between SES inequality and cardiovascular disease and consequently premature death. The aim of this study is to test which life course model best describes the association between socioeconomic disadvantage and obesity among 60 year old inhabitants of Västerbotten County in Northern Sweden. A birth cohort consisting of 3340 individuals born between 1930 and 1932 was studied. Body mass index (BMI) at the age of 60 and information on socioeconomic status at three stages of life (ages 40, 50, and 60 years) was collected. Independent samples t-test was used to compare BMI between advantaged and disadvantaged groups and one-way ANOVA was used to compare BMI among eight SES trajectories. We applied a structured modeling approach to examine three different hypothesized life course SES models (accumulation, critical period, and social mobility) in relation to BMI. We found sex differences in the way that late adulthood socioeconomic disadvantage is associated with BMI among inhabitants of Northern Sweden. Our study suggests that social adversity in all stages of late adulthood is a particularly important indicator for addressing the social gradients in BMI among women in Northern Sweden and that unhealthy behaviors in terms of smoking and physical inactivity are insufficient to explain the relationships between social and lifestyle inequalities and BMI. In order for local authorities to develop informed preventive efforts, we suggest further research to identify modifiable risk factors across the life course which could explain this health inequality.

Income inequality and depression: a systematic review and meta-analysis of the association and a scoping review of mechanisms.

PubMed

Patel, Vikram; Burns, Jonathan K; Dhingra, Monisha; Tarver, Leslie; Kohrt, Brandon A; Lund, Crick

2018-02-01

Most countries have witnessed a dramatic increase of income inequality in the past three decades. This paper addresses the question of whether income inequality is associated with the population prevalence of depression and, if so, the potential mechanisms and pathways which may explain this association. Our systematic review included 26 studies, mostly from high-income countries. Nearly two-thirds of all studies and five out of six longitudinal studies reported a statistically significant positive relationship between income inequality and risk of depression; only one study reported a statistically significant negative relationship. Twelve studies were included in a meta-analysis with dichotomized inequality groupings. The pooled risk ratio was 1.19 (95% CI: 1.07-1.31), demonstrating greater risk of depression in populations with higher income inequality relative to populations with lower inequality. Multiple studies reported subgroup effects, including greater impacts of income inequality among women and low-income populations. We propose an ecological framework, with mechanisms operating at the national level (the neo-material hypothesis), neighbourhood level (the social capital and the social comparison hypotheses) and individual level (psychological stress and social defeat hypotheses) to explain this association. We conclude that policy makers should actively promote actions to reduce income inequality, such as progressive taxation policies and a basic universal income. Mental health professionals should champion such policies, as well as promote the delivery of interventions which target the pathways and proximal determinants, such as building life skills in adolescents and provision of psychological therapies and packages of care with demonstrated effectiveness for settings of poverty and high income inequality. © 2018 World Psychiatric Association.

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

PubMed Central

Patel, Vikram; Burns, Jonathan K.; Dhingra, Monisha; Tarver, Leslie; Kohrt, Brandon A.; Lund, Crick

2018-01-01

Most countries have witnessed a dramatic increase of income inequality in the past three decades. This paper addresses the question of whether income inequality is associated with the population prevalence of depression and, if so, the potential mechanisms and pathways which may explain this association. Our systematic review included 26 studies, mostly from high‐income countries. Nearly two‐thirds of all studies and five out of six longitudinal studies reported a statistically significant positive relationship between income inequality and risk of depression; only one study reported a statistically significant negative relationship. Twelve studies were included in a meta‐analysis with dichotomized inequality groupings. The pooled risk ratio was 1.19 (95% CI: 1.07‐1.31), demonstrating greater risk of depression in populations with higher income inequality relative to populations with lower inequality. Multiple studies reported subgroup effects, including greater impacts of income inequality among women and low‐income populations. We propose an ecological framework, with mechanisms operating at the national level (the neo‐material hypothesis), neighbourhood level (the social capital and the social comparison hypotheses) and individual level (psychological stress and social defeat hypotheses) to explain this association. We conclude that policy makers should actively promote actions to reduce income inequality, such as progressive taxation policies and a basic universal income. Mental health professionals should champion such policies, as well as promote the delivery of interventions which target the pathways and proximal determinants, such as building life skills in adolescents and provision of psychological therapies and packages of care with demonstrated effectiveness for settings of poverty and high income inequality. PMID:29352539

Inequality and City Size*

PubMed Central

Baum-Snow, Nathaniel; Pavan, Ronni

2013-01-01

Between 1979 and 2007 a strong positive monotonic relationship between wage inequality and city size has developed. This paper investigates the links between this emergent city size inequality premium and the contemporaneous nationwide increase in wage inequality. After controlling for the skill composition of the workforce across cities of different sizes, we show that at least 23 percent of the overall increase in the variance of log hourly wages in the United States from 1979 to 2007 is explained by the more rapid growth in the variance of log wages in larger locations relative to smaller locations. This influence occurred throughout the wage distribution and was most prevalent during the 1990s. More rapid growth in within skill group inequality in larger cities has been by far the most important force driving these city size specific patterns in the data. Differences in the industrial composition of cities of different sizes explain up to one-third of this city size effect. These results suggest an important role for agglomeration economies in generating changes in the wage structure during the study period. PMID:24954958

Declaring Bankruptcy on Educational Inequity

ERIC Educational Resources Information Center

Bass, Lisa; Gerstl-Pepin, Cynthia

2011-01-01

The authors consider Ladson-Billings' (2006) charge to reframe the way the "achievement gap" is viewed, and put forth the metaphor of "bankruptcy" as a way to acknowledge the educational debt and educational inequity and move towards debt forgiveness in public education. Specifically, the bankruptcy metaphor is used to examine…

Uneven Terrain: Educational Policy and Equity in Nepal

ERIC Educational Resources Information Center

Shields, Robin; Rappleye, Jeremy

2008-01-01

This paper investigates the relationship between educational policy, equity, and national development in Nepal. It argues that current inequities in educational opportunities and outcomes are largely attributable to persistent inequities and biases in the educational policy framework. We begin by surveying the complex, multifaceted reality of…

Toward a New Understanding of Community-Based Education: The Role of Community-Based Educational Spaces in Disrupting Inequality for Minoritized Youth

ERIC Educational Resources Information Center

Baldridge, Bianca J.; Beck, Nathan; Medina, Juan Carlos; Reeves, Marlo A.

2017-01-01

Community-based educational spaces (CBES; afterschool programs, community-based youth organizations, etc.) have a long history of interrupting patterns of educational inequity and continue to do so under the current educational policy climate. The current climate of education, marked by neoliberal education restructuring, has left community-based…

Student-Centered Instruction and Academic Achievement: Linking Mechanisms of Educational Inequality to Schools' Instructional Strategy

ERIC Educational Resources Information Center

Andersen, Ida Gran; Andersen, Simon Calmar

2017-01-01

Research in the sociology of education argues that the educational system provides different learning opportunities for students with different socioeconomic backgrounds and that this circumstance makes the educational process an important institutional context for the reproduction of educational inequality. Using combined survey and register data…

Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988 - 2008.

PubMed

Asamoah, Benedict O; Agardh, Anette; Pettersson, Karen Odberg; Östergren, Per-Olof

2014-08-29

Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth. This study therefore aimed at investigating the magnitude and trends in income-, education-, residence-, and parity-related inequalities in access to antenatal care and skilled attendance at birth. A database was constructed using data from the Ghana Demographic and Health Surveys (DHS) 1988, 1993, 1998, 2003, and 2008. The surveys employed standard DHS questionnaires and techniques for data collection. We applied regression-based Total Attributable Fraction (TAF) as an index for measuring socioeconomic inequalities in antenatal care and skilled birth attendance utilization. The rural-urban gap and education-related inequalities in the utilization of antenatal care and skilled birth attendants seem to be closing over time, while income- and parity-related inequalities in the use of antenatal care are on a sharp rise. Income inequality regarding the utilization of skilled birth attendance was rather low and stable from 1988 to 1998, increased sharply to a peak between 1998 and 2003, and then leveled-off after 2003. The increased income-related inequalities seen in the use of antenatal care and skilled birth attendance should be addressed through appropriate strategies. Intensifying community-based health education through media and door-to-door campaigns could further reduce the mentioned education- and parity-related inequalities. Women should be highly motivated and incentivized to attend school up to secondary level or higher. Education on the use of maternal health services should be integrated into basic schools so that women at the lowest level would be inoculated with the appropriate health messages.

Does the socioeconomic context explain both mortality and income inequality? Prospective register-based study of Norwegian regions

PubMed Central

2011-01-01

Background Studies from various countries have observed worse population health in geographical areas with more income inequality. The psychosocial interpretation of this association is that large income disparities are harmful to health because they generate relative deprivation and undermine social cohesion. An alternative explanation contends that the association between income inequality and ill health arises because the underlying social and economic structures will influence both the level of illness and disease and the size of income differences. This paper examines whether the observed association between mortality and income inequality in Norwegian regions can be accounted for by the socioeconomic characteristics of the regions. Methods Norwegian register data covering the entire population were utilised. An extensive set of contextual and individual predictors were included in multilevel Poisson regression analyses of mortality 1994-2003 among 1.6 millions individuals born 1929-63, distributed across 35 residential regions. Results Mean income, composition of economic branches, and percentage highly educated in the regions were clearly connected to the level of income inequality. These social and economic characteristics of the regions were also markedly related to regional mortality levels, after adjustment for population composition, i.e., the individual-level variables. Moreover, regional mortality was significantly higher in regions with larger income disparities. The regions' social and economic structure did not, however, account for the association between regional income inequality and mortality. A distinct independent effect of income inequality on mortality remained after adjustment for regional-level social and economic characteristics. Conclusions The results indicate that the broader socioeconomic context in Norwegian regions has a substantial impact both on mortality and on the level of income disparities. However, the results also suggest, in a way compatible with the psychosocial interpretation, that on top of the general socioeconomic influences, a higher level of income inequality adds independently to higher mortality levels. Previous publication This article is a reworked version of the study 'Er inntektsforskjeller dødelige?' [Are income inequalities lethal?] which was published in Norwegian in Tidsskrift for velferdsforskning [Journal for welfare research], Vol. 13 (4), 2010. PMID:21291530

Rising U.S. income inequality and the changing gradient of socioeconomic status on physical functioning and activity limitations, 1984-2007.

PubMed

Zheng, Hui; George, Linda K

2012-12-01

This study examines the interactive contextual effect of income inequality on health. Specifically, we hypothesize that income inequality will moderate the relationships between individual-level risk factors and health. Using National Health Interview Survey data 1984-2007 (n = 607,959) and U.S. Census data, this paper estimates the effect of the dramatic increase in income inequality in the U.S. over the past two decades on the gradient of socioeconomic status on two measures of health (i.e., physical functioning and activity limitations). Results indicate that increasing income inequality strengthens the protective effects of family income, employment, college education, and marriage on these two measures of health. In contrast, high school education's protective effect (relative to less than a high school education) weakens in the context of increasing income inequality. In addition, we find that increasing income inequality exacerbates men's disadvantages in physical functioning and activity limitations. These findings shed light on research about growing health disparities in the U.S. in the last several decades. Copyright © 2012 Elsevier Ltd. All rights reserved.

Educational Inequalities in Obesity among Mexican Women: Time-Trends from 1988 to 2012

PubMed Central

Perez Ferrer, Carolina; McMunn, Anne; Rivera Dommarco, Juan A.; Brunner, Eric J.

2014-01-01

Background Obesity is one of the leading causes of global morbidity and mortality. Trends in educational inequalities in obesity prevalence among Mexican women have not been analysed systematically to date. Methods Data came from four nationally representative surveys (1988, 1999, 2006, and 2012) of a total of 51 220 non-pregnant women aged 20 to 49. Weight and height were measured during home visits. Education level (higher education, high school, secondary, primary or less) was self-reported. We analysed trends in relative and absolute educational inequalities in obesity prevalence separately for urban and rural areas. Results Nationally, age-standardised obesity prevalence increased from 9.3% to 33.7% over 25 years to 2012. Obesity prevalence was inversely associated with education level in urban areas at all survey waves. In rural areas, obesity prevalence increased markedly but there was no gradient with education level at any survey. The relative index of inequality in urban areas declined over the period (2.87 (95%CI: 1.94, 4.25) in 1988, 1.55 (95%CI: 1.33, 1.80) in 2012, trend p<0.001). Obesity increased 5.92 fold (95%CI: 4.03, 8.70) among urban women with higher education in the period 1988–2012 compared to 3.23 fold (95%CI: 2.88, 3.63) for urban women with primary or no education. The slope index of inequality increased in urban areas from 1988 to 2012. Over 0.5 M cases would be avoided if the obesity prevalence of women with primary or less education was the same as for women with higher education. Conclusions The expected inverse association between education and obesity was observed in urban areas of Mexico. The declining trend in relative educational inequalities in obesity was due to a greater increase in obesity prevalence among higher educated women. In rural areas there was no social gradient in the association between education level and obesity across the four surveys. PMID:24599098

Educational inequalities in obesity among Mexican women: time-trends from 1988 to 2012.

PubMed

Perez Ferrer, Carolina; McMunn, Anne; Rivera Dommarco, Juan A; Brunner, Eric J

2014-01-01

Obesity is one of the leading causes of global morbidity and mortality. Trends in educational inequalities in obesity prevalence among Mexican women have not been analysed systematically to date. Data came from four nationally representative surveys (1988, 1999, 2006, and 2012) of a total of 51 220 non-pregnant women aged 20 to 49. Weight and height were measured during home visits. Education level (higher education, high school, secondary, primary or less) was self-reported. We analysed trends in relative and absolute educational inequalities in obesity prevalence separately for urban and rural areas. Nationally, age-standardised obesity prevalence increased from 9.3% to 33.7% over 25 years to 2012. Obesity prevalence was inversely associated with education level in urban areas at all survey waves. In rural areas, obesity prevalence increased markedly but there was no gradient with education level at any survey. The relative index of inequality in urban areas declined over the period (2.87 (95%CI: 1.94, 4.25) in 1988, 1.55 (95%CI: 1.33, 1.80) in 2012, trend p<0.001). Obesity increased 5.92 fold (95%CI: 4.03, 8.70) among urban women with higher education in the period 1988-2012 compared to 3.23 fold (95%CI: 2.88, 3.63) for urban women with primary or no education. The slope index of inequality increased in urban areas from 1988 to 2012. Over 0.5 M cases would be avoided if the obesity prevalence of women with primary or less education was the same as for women with higher education. The expected inverse association between education and obesity was observed in urban areas of Mexico. The declining trend in relative educational inequalities in obesity was due to a greater increase in obesity prevalence among higher educated women. In rural areas there was no social gradient in the association between education level and obesity across the four surveys.

Literacy Inequalities in Theory and Practice: The Power to Name and Define

ERIC Educational Resources Information Center

Street, Brian V.

2011-01-01

I analyse what exactly is being addressed when the notion of "literacy inequalities" is cited in the context of international policy with regard to education in general and literacy in particular. Whilst literacy statistics are used as indicators of social inequality and as a basis for policy in improving rights, educational attainment, etc., I…

Inequities in Computer Education Due to Gender, Race, and Socioeconomic Status.

ERIC Educational Resources Information Center

Urban, Cynthia M.

Recent reports have revealed that inequalities exist between males and females, racial minorities and whites, and rich and poor in accessibility to and use of computers. This study reviews the research in the field of computer-based education to determine the extent of and reasons for these inequities. The annotated research articles are arranged…

Educational Inequality in the United States: Can We Reverse the Tide?

ERIC Educational Resources Information Center

Gamoran, Adam; Bruch, Sarah K.

2017-01-01

Educational inequality is a pressing problem in much of the English-speaking world and especially in the United States, as the last three decades have witnessed rising inequality on several measures. This is an appropriate subject for a special issue commemorating the contributions of David Raffe, whose career of scholarship greatly enhanced our…

One-Dimensional School Rankings: A Non-Neutral Device that Conceals and Naturalises Inequalities

ERIC Educational Resources Information Center

Neves, Tiago; Pereira, Maria Joao; Nata, Gil

2012-01-01

Inequality has long been a central topic in the social sciences. The same holds true with regard to sociological research on education. In this paper we argue that, due to fairly recent developments in the managerialisation and marketisation of the educational field, often associated with the rise of neoliberalism, the topic of inequality gains…

Decomposing socioeconomic inequality in child vaccination: results from Ireland.

PubMed

Doherty, Edel; Walsh, Brendan; O'Neill, Ciaran

2014-06-05

There is limited knowledge of the extent of or factors underlying inequalities in uptake of childhood vaccination in Ireland. This paper aims to measure and decompose socioeconomic inequalities in childhood vaccination in the Republic of Ireland. The analysis was performed using data from the first wave of the Growing Up in Ireland survey, a nationally representative survey of the carers of over 11,000 nine-month old babies collected in 2008 and 2009. Multivariate analysis was conducted to explore the child and parental factors, including socioeconomic factors that were associated with non-vaccination of children. A concentration index was calculated to measure inequality in childhood vaccination. Subsequent decomposition analysis identified key factors underpinning observed inequalities. Overall the results confirm a strong socioeconomic gradient in childhood vaccination in the Republic of Ireland. Concentration indices of vaccination (CI=-0.19) show a substantial pro-rich gradient. Results from the decomposition analysis suggest that a substantial proportion of the inequality is explained by household level variables such as socioeconomic status, household structure, income and entitlement to publicly funded care (29.9%, 24% 30.6% and 12.9% respectively). Substantial differences are also observed between children of Irish mothers and immigrant mothers from developing countries. Vaccination was less likely in lower than in higher income households. Access to publicly funded services was an important factor in explaining inequalities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: Why we should measure them all

PubMed Central

2014-01-01

Introduction Regular reporting of health inequalities is essential to monitoring progress of efforts to reduce health inequalities. While reporting of population health became increasingly common, reporting of a subpopulation group breakdown of each indicator of the health of the population is rarely a standard practice. This study reports education-, sex-, and race-related inequalities in four health outcomes in each of the selected 93 counties in the United States in a systematic and comparable manner. Methods This study is a cross-sectional analysis of large, publicly available data, 2008, 2009, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) Selected Metropolitan/Micropolitan Area Risk Trends (SMART) and 2008, 2009, and 2010 United States Birth Records from the National Vital Statistics System. The study population is American adults older than 25 years of age residing in the selected 93 counties, representing about 30% of the US population, roughly equally covering all geographic regions of the country. Main outcome measures are: (1) Attribute (group characteristic)-specific inequality: education-, sex-, or race-specific inequality in each of the four health outcomes (poor or fair health, poor physical health days, poor mental health days, and low birthweight) in each county; (2) Overall inequality: the average of these three attribute-specific inequalities for each health outcome in each county; and (3) Summary inequality in total morbidity: the weighted average of the overall inequalities across the four health outcomes in each county. Results The range of inequality across the counties differed considerably by health outcome; inequality in poor or fair health had the widest range and the highest median among inequalities in all health outcomes. In more than 70% of the counties, education-specific inequality was the largest in all health outcomes except for low birthweight. Conclusions It is feasible to extend population health reporting to include reporting of a subpopulation group breakdown of each indicator of the health of the population at a small jurisdictional level using publicly available data. No single group characteristic or health outcome represents the whole picture of health inequalities in a population. Examining multiple group characteristics and outcomes in a comparable manner is essential in reporting health inequalities. PMID:24927805

Education, Productivity and Inequality: The East African Natural Experiment.

ERIC Educational Resources Information Center

Knight, John B.; Sabot, Richard H.

The relationship between resources devoted to education and the economy of developing nations is explored. The research seeks to understand if and how investment in education translates into increased economic growth and labor productivity. Additionally, the function of education in reducing various dimensions of economic inequality is examined.…

Are Educational Mismatches Responsible for the "Inequality Increasing Effect" of Education?

ERIC Educational Resources Information Center

Budria, Santiago

2011-01-01

This paper asks whether educational mismatches can account for the positive association between education and wage inequality found in the data. We use two different data sources, the European Community Household Panel and the Portuguese Labour Force Survey, and consider several types of mismatch, including overqualification, underqualification…

Educational Expansion and Inequality in Taiwan and the Czech Republic

ERIC Educational Resources Information Center

Smith, Michael; Tsai, Shu-Ling; Mateju, Petr; Huang, Min-Hsiung

2016-01-01

This article presents a comparative analysis of educational inequality by family background and gender in Taiwan and the Czech Republic, which have both experienced substantial educational expansion in the last half-century under different educational systems. We highlight the specific institutional histories of both countries and examine the role…

Undermining Critical Consciousness Unconsciously: Restoring Hope in the Multicultural Education Idea

ERIC Educational Resources Information Center

Gatimu, M. Wangeci

2009-01-01

The main goal of multicultural education is to transform the structural factors in the educational system in order to redress inequalities and inequities for historically underprivileged populations (Banks "1997"). This article addresses theories and practices that frame multicultural education in teaching and learning contexts. How do teachers…

Contradictions of Identity: Education and the Problem of Racial Absolutism.

ERIC Educational Resources Information Center

McCarthy, Cameron

1995-01-01

Critiques tendencies toward dogmatism and essentialism in current educational theories of racial inequality. Argues that different gender, class, and ethnic interests intersect with racial coordination and affiliation, and that to reduce racial antagonism or ameliorate educational inequities educators must consider the powerful role of nuance,…

Science in Educational Administration: A Comment on the Holmes-Greenfield Dialogue [and] Absolutism and Educational Administration: A Response to Ryan.

ERIC Educational Resources Information Center

Ryan, James J.; Holmes, Mark

1988-01-01

Two articles comment on the debate over the utility of science in educational administration. Critiques of various positions on the topic point out the possible effects of conservatism and positivism on inequality and inequity in educational administration. (CB)

Quantifying the mediating effects of smoking and occupational exposures in the relation between education and lung cancer: the ICARE study.

PubMed

Menvielle, Gwenn; Franck, Jeanna-Eve; Radoï, Loredana; Sanchez, Marie; Févotte, Joëlle; Guizard, Anne-Valérie; Stücker, Isabelle; Luce, Danièle

2016-12-01

Smoking only partly explains the higher lung cancer incidence observed among socially deprived people. Occupational exposures may account for part of these inequalities, but this issue has been little investigated. We investigated the extent to which smoking and occupational exposures to asbestos, silica and diesel motor exhaust mediated the association between education and lung cancer incidence in men. We analyzed data from a large French population-based case-control study (1976 lung cancers, 2648 controls). Detailed information on lifelong tobacco consumption and occupational exposures to various carcinogens was collected. We conducted inverse probability-weighted marginal structural models. A strong association was observed between education and lung cancer. The indirect effect through smoking varied by educational level, with the strongest indirect effect observed for those with the lowest education (OR = 1.34 (1.14-1.57)). The indirect effect through occupational exposures was substantial among men with primary (OR = 1.22 (1.15-1.30) for asbestos and silica) or vocational secondary education (OR = 1.18 (1.12-1.25)). The contribution of smoking to educational differences in lung cancer incidence ranged from 22 % (10-34) for men with primary education to 31 % (-3 to 84) for men with a high school degree. The contribution of occupational exposures to asbestos and silica ranged from 15 % (10-20) for men with a high school degree to 20 % (13-28) for men with vocational secondary education. Our results highlight the urgent need for public health policies that aim at decreasing exposure to carcinogens at work, in addition to tobacco control policies, if we want to reduce socioeconomic inequalities in the cancer field.

Health inequalities according to educational level in different welfare regimes: a comparison of 23 European countries.

PubMed

Eikemo, Terje A; Huisman, Martijn; Bambra, Clare; Kunst, Anton E

2008-05-01

The object of this study was to determine whether the magnitude of educational health inequalities varies between European countries with different welfare regimes. The data source is based on the first and second wave of the European Social Survey. The first health indicator describes people's mental and physical health in general, while the second reports cases of any limiting longstanding illness. Educational inequalities in health were measured as the difference in health between people with an average number of years of education and people whose educational years lay one standard deviation below the national average. Moreover, South European welfare regimes had the largest health inequalities, while countries with Bismarckian welfare regimes tended to demonstrate the smallest. Although the other welfare regimes ranked relatively close to each other, the Scandinavian welfare regimes were placed less favourably than the Anglo-Saxon and East European. Thus, this study shows an evident patterning of magnitudes of health inequalities according to features of European welfare regimes. Although the greater distribution of welfare benefits within the Scandinavian countries are likely to have a protective effect for disadvantaged cities in these countries, other factors such as relative deprivation and class-patterned health behaviours might be acting to widen health inequalities.

Socioeconomic inequalities in health care utilisation in Norway: the population-based HUNT3 survey.

PubMed

Vikum, Eirik; Krokstad, Steinar; Westin, Steinar

2012-08-22

In this study we investigated the distribution of self-reported health care utilisation by education and household income in a county population in Norway, in a universal public health care system based on ideals of equal access for all according to need, and not according to wealth. The study included 24,147 women and 20,608 men aged 20 years and above in the third Nord-Trøndelag Health Survey (HUNT 3) of 2006-2008. Income-related horizontal inequity was estimated through concentration indexes, and inequity by both education and income was estimated as risk ratios through conventional regression. We found no overall pro-rich or pro-educated socioeconomic gradient in needs-adjusted utilisation of general practitioner or inpatient care. However, we found overall pro-rich and pro-educated inequity in utilisation of both private medical specialists and hospital outpatient care. For these services there were large differences in levels of inequity between younger and older men and women. In contrast with recent studies from Norway, we found pro-rich and pro-educated social inequalities in utilisation of hospital outpatient services and not only private medical specialists. Utilisation of general practitioner and inpatient services, which have low access threshold or are free of charge, we found to be equitable.

Educational inequalities in smoking among Japanese adults aged 25-94 years: Nationally representative sex- and age-specific statistics.

PubMed

Tabuchi, Takahiro; Kondo, Naoki

2017-04-01

Few studies have investigated differences in age- and gender-specific educational gradients in tobacco smoking among the whole range of adult age groups. We examined educational inequality in smoking among Japanese adults aged 25-94 years. Using a large nationally representative sample (167,925 men and 186,588 women) in 2010, prevalence of current smoking and heavy smoking among daily smokers and their inequalities attributable to educational attainment were analyzed according to sex and age groups. Among men aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 68.4% (95% confidence interval [CI], 66.0%-70.6%), and graduate school graduates had the lowest at 19.4% (95% CI, 17.2%-21.9%). High school graduates had the second highest current smoking prevalence (e.g., 55.9%; 95% CI, 54.9%-56.8% in men aged 25-34 years). Among men aged 75-94 years, the difference in current smoking across educational categories was small. A similar but steeper educational gradient in current smoking was observed among women. Among women aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 49.3% (95% CI, 46.3%-52.3%), and graduate school graduates had the lowest at 4.8% (95% CI, 2.9%-7.4%). Compared with older age groups, such as 65-94 years, younger age groups, such as 25-54 years, had higher estimates of inequality indicators for educational inequality in both current and heavy smoking in both sexes. Educational inequalities in current and heavy smoking were apparent and large in the young population compared with older generations. The current study provides basic data on educational inequalities in smoking among Japanese adults. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Disadvantaged populations in maternal health in China who and why?

PubMed Central

Yuan, Beibei; Qian, Xu; Thomsen, Sarah

2013-01-01

Background China has made impressive progress towards the Millennium Development Goal (MDG) for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. Methods We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. Results In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Conclusions Inequity in maternal health continues to be an issue worthy of greater programmatic and monitoring efforts in China. PMID:23561030

An equity analysis of utilization of health services in Afghanistan using a national household survey.

PubMed

Kim, Christine; Saeed, Khwaja Mir Ahad; Salehi, Ahmad Shah; Zeng, Wu

2016-12-05

Afghanistan has made great strides in the coverage of health services across the country but coverage of key indicators remains low nationally and whether the poorest households are accessing these services is not well understood. We analyzed the Afghanistan Mortality Survey 2010 on utilization of inpatient and outpatient care, institutional delivery and antenatal care by wealth quintiles. Concentration indexes (CIs) were generated to measure the inequality of using the four services. Additional analyses were conducted to examine factors that explain the health inequalities (e.g. age, gender, education and residence). Among households reporting utilization of health services, public health facilities were used more often for inpatient care, while they were used less for outpatient care. Overall, the utilization of inpatient and outpatient care, and antenatal care was equally distributed among income groups, with CIs of 0.04, 0.03 and 0.08, respectively. However, the poor used more public facilities while the wealthy used more private facilities. There was a substantial inequality in the use of institutional delivery services, with a CI of 0.31. Poorer women had a lower rate of institutional deliveries overall, in both public and private facilities, compared to the wealthy. Location was an important factor in explaining the inequality in the use of health services. The large gap between the rich and poor in access to and utilization of key maternal services, such as institutional delivery, may be a central factor to the high rates of maternal mortality and morbidity and impedes efforts to make progress toward universal health coverage. While poorer households use public health services more often, the use of public facilities for outpatient visits remains half that of private facilities. Pro-poor targeting as well as a better understanding of the private sector's role in increasing equitable coverage of maternal health services is needed. Equity-oriented approaches in health should be prioritized to promote more inclusive health system reforms.

The social gradient in work and health: a cross-sectional study exploring the relationship between working conditions and health inequalities

PubMed Central

2013-01-01

Background Social inequalities in health are widely examined. But the reasons behind this phenomenon still remain unclear in parts. It is undisputed that the work environment plays a crucial role in this regard. However, the contribution of psychosocial factors at work is unclear and inconsistent, and most studies are limited with regard to work factors and health outcomes. This study, therefore, aimed to explore the role and contribution of various physical and psychosocial working conditions to explaining social inequalities in different self-reported health outcomes. Methods Data from a postal survey among the workforces of four medium-sized and large companies from diverse industries of the secondary sector in Switzerland were used and analysed. The study sample covered 1,846 employees aged 20 and 64 and included significant proportions of unskilled manual workers and highly qualified non-manual workers. Cross tabulations and logistic regression analyses were performed to study multiple associations between social status, work factors and health outcomes. Combinations of educational level and occupational position wee used as a measure of social status or class. Results Clear social gradients were observed for almost all adverse working conditions and poor health outcomes studied, but in different directions. While physical workloads and other typical blue-collar job characteristics not suprisingly, were found to be much more common among the lower classes, most psychosocial work demands and job resources were more prevalent in the higher classes. Furthermore, workers in lower classes, i.e. with lower educational and occupational status, were more likely to report poor self-rated health, limited physical functioning and long sickness absence, but at the same time were less likely to experience increased stress feelings and burnout symptoms showing a reversed health gradient. Finally, blue-collar job characteristics contributed substantially to the social gradient found in general and physical health outcomes. In contrast, white-collar job characteristics made no contribution to explaining the gradient in these health outcomes, but instead largely explained the reversed social gradient observed for the mental health outcomes. Conclusion The findings suggest a more differentiated pattern of the commonly found social gradient in health and the differential role of work in this respect. PMID:24330543

The Relationship between Income Inequality and Inequality in Schooling

ERIC Educational Resources Information Center

Mayer, Susan E.

2010-01-01

Children of affluent parents get more schooling than children of poor parents, which seems to imply that reducing income inequality would reduce inequality in schooling. Similarly, one of the best predictors of an individual's income is his educational attainment, which seems to imply that reducing inequality in schooling will reduce income…

Beyond the Birds and the Bees: Learning Inequality through Sexuality Education

ERIC Educational Resources Information Center

Connell, Catherine; Elliott, Sinikka

2009-01-01

This article reviews the literature on the roles that schools, peers, and parents play in young people's sexuality education. We argue that the sexuality education children receive is far from just the facts; rather, it is an education in the maintenance of inequality. Sexuality education, as it is currently conceived, includes implicit and…

Does the distribution of healthcare utilization match needs in Africa?

PubMed

Bonfrer, Igna; van de Poel, Ellen; Grimm, Michael; Van Doorslaer, Eddy

2014-10-01

An equitable distribution of healthcare use, distributed according to people's needs instead of ability to pay, is an important goal featuring on many health policy agendas worldwide. However, relatively little is known about the extent to which this principle is violated across socio-economic groups in Sub-Saharan Africa (SSA). We examine cross-country comparative micro-data from 18 SSA countries and find that considerable inequalities in healthcare use exist and vary across countries. For almost all countries studied, healthcare utilization is considerably higher among the rich. When decomposing these inequalities we find that wealth is the single most important driver. In 12 of the 18 countries wealth is responsible for more than half of total inequality in the use of care, and in 8 countries wealth even explains more of the inequality than need, education, employment, marital status and urbanicity together. For the richer countries, notably Mauritius, Namibia, South Africa and Swaziland, the contribution of wealth is typically less important. As the bulk of inequality is not related to need for care and poor people use less care because they do not have the ability to pay, healthcare utilization in these countries is to a large extent unfairly distributed. The weak average relationship between need for and use of health care and the potential reporting heterogeneity in self-reported health across socio-economic groups imply that our findings are likely to even underestimate actual inequities in health care. At a macro level, we find that a better match of needs and use is realized in those countries with better governance and more physicians. Given the absence of social health insurance in most of these countries, policies that aim to reduce inequities in access to and use of health care must include an enhanced capacity of the poor to generate income. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

The Price of Inequality

ERIC Educational Resources Information Center

Jensen, Arthur R.

1975-01-01

Some of the key problems of educational equality -- equality of opportunities and inequality of performance; individual differences vs. group differences, coping with group inequality -- are made explicit. (Author/KM)

Ethnic Differences in Elders' Home Remedy Use: Sociostructural Explanations

PubMed Central

Grzywacz, Joseph G.; Arcury, Thomas A.; Bell, Ronny A.; Lang, Wei; Suerken, Cynthia K.; Smith, Shannon L.; Quandt, Sara A.

2006-01-01

Objective: To determine if ethnic differences in elders' use of home remedies are explained by structured inequalities. Method: Dichotomous indicators of “food” and “other” home remedies were obtained from a randomly selected cohort of older adults with diabetes (N=701). Analyses evaluated if differences in availability of care, economic hardship, and health status explained ethnic differences in home remedy use. Results: Differences in residential location, discretionary money, and health partially explained greater home remedy use among Black and Native American elders relative to whites. Conclusions: Ethnic differences in elders' use of home remedies are not largely attributed to socially structured inequalities. PMID:16430319

Family structure and income inequality in families with children, 1976 to 2000.

PubMed

Martin, Molly A

2006-08-01

Using 24 years of data from the March supplements to the Current Population Survey and detailed categories of family structure, including cohabiting unions, I assess the contribution of changes in family structure to the dramatic rise in family income inequality. Between 1976 and 2000, family structure shifts explain 41% of the increase in inequality, but the influence of family structure change is not uniform within this period or across racial-ethnic groups. In general, the estimated role of family structure change is inversely related to the magnitude of the changes in inequality. Furthermore, by including cohabitation, I find lower levels of total inequality and a weaker role for demographic shifts in family structure for trends in income inequality.

Do Changes in Job Mobility Explain the Growth of Wage Inequality among Men in the United States, 1977-2005?

ERIC Educational Resources Information Center

Mouw, Ted; Kalleberg, Arne L.

2010-01-01

To what extent did the increase in wage inequality among men in the United States over the past three decades result from job loss and/or employment instability? We propose a simple method for decomposing the change in wage inequality into components due to upward and downward between-employer mobility and within-employer wage changes using data…

Racial Inequity in Special Education.

ERIC Educational Resources Information Center

Losen, Daniel J., Ed.; Orfield, Gary, Ed.

This collection of papers discusses issues related to the overidentification of minority students in special education. After a "Foreword" (Senator James M. Jeffords) and an introduction, "Racial Inequality in Special Education" (Daniel J. Losen and Gary Orfield), 11 chapters include: (1) "Community and School Predictors…

Confronting the Labor Problem in Catholic Higher Education: Applying Catholic Social Teaching in an Age of Increasing Inequality

ERIC Educational Resources Information Center

McCartin, Joseph A.

2018-01-01

Over the past four decades, the United States has witnessed the rise of an economy of growing inequality and exploitation, and this economic transformation has entangled Catholic institutions of higher education in what Pope Francis has called "an economy of exclusion and inequality." In recent years, some institutions have taken steps…

Income Inequality, the Median Voter, and the Support for Public Education. NBER Working Paper No. 16097

ERIC Educational Resources Information Center

Corcoran, Sean; Evans, William N.

2010-01-01

Using a panel of U.S. school districts spanning 1970-2000, we examine the relationship between income inequality and fiscal support for public education. In contrast with recent theoretical and empirical work suggesting a negative relationship between inequality and public spending, we find results consistent with a median voter model, in which…

What Are the Causes of Educational Inequality and of Its Evolution over Time in Europe? Evidence from PISA

ERIC Educational Resources Information Center

Oppedisano, Veruska; Turati, Gilberto

2015-01-01

This paper provides evidence on the sources of differences in inequality in educational scores and their evolution over time in four European countries. Using Programme for International Student Assessment data from the 2000 and the 2006 waves, the paper shows that inequality decreased in Germany and Spain (two "decentralised" schooling…

Anatomies of Inequality: Considering the Emotional Cost of Aiming Higher for Marginalised, Mature Mothers Re-Entering Education

ERIC Educational Resources Information Center

Mannay, Dawn; Morgan, Melanie

2013-01-01

The "Anatomy of Economic Inequality in Wales" (2011) provides quantitative evidence for the pervasive nature of class-based inequalities in education, demonstrating that an individual in social housing is approximately 10 times less likely to be a graduate compared to those in other types of accommodation. This article moves beyond the…

Gender and Faculty Rank: An Analysis of Doctoral-Granting Universities by United States Regions

ERIC Educational Resources Information Center

Strassberg, Petra

2013-01-01

Over the last 50 years there has been a great deal of research focused on gender inequity in higher education in the U.S. These studies have been limited to individual or regional universities, or discussions on the possible causes of gender inequity in the area of higher education. This study examines gender inequity at doctoral-granting…

Forty years of economic growth and plummeting mortality: the mortality experience of the poorly educated in South Korea.

PubMed

Bahk, Jinwook; Lynch, John W; Khang, Young-Ho

2017-03-01

South Korea has experienced rapid economic development and a substantial increase in life expectancy in an extremely short period. Whether this rapid development has been able to adequately address inequalities in health in South Korea may have important policy implications. This paper explores long-term trends in inequalities in mortality related to education in South Korea between 1970 and 2010. We used secondary data on population size and deaths in 1970 and 1980 from a previously published study, and census and death certificate data from Statistics Korea from 1990, 1995, 2000, 2005 and 2010. Trends in age-standardised mortality rates for men and women aged 25-64 according to education, as well as the rate ratio (RR), rate difference (RD), relative index of inequality (RII) and slope index of inequality (SII), were examined over the period 1970-2010. Despite overall mortality declines of 70-80% in the past 4 decades, educational inequalities have increased or been stagnant. There was minimal decline in mortality since 1970 in South Koreans with only a primary or lower level of education. The RR and RD between tertiary education and primary or lower education increased over the study period, while the RII and the SII in both genders remained stable. The South Korean experience over the past 40 years suggests that plummeting mortality rates and huge advances in education at the population level do not translate into reduced educational inequalities in mortality. 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/.

Changes in Socio-Economic Inequality in Neonatal Mortality in Iran Between 1995-2000 and 2005-2010: An Oaxaca Decomposition Analysis

PubMed Central

Amini Rarani, Mostafa; Rashidian, Arash; Khosravi, Ardeshir; Arab, Mohammad; Abbasian, Ezatollah; Khedmati Morasae, Esmaeil

2017-01-01

Background: Exploring changes in health inequality and its determinants over time is of policy interest. Accordingly, this study aimed to decompose inequality in neonatal mortality into its contributing factors and then explore changes from 1995-2000 to 2005-2010 in Iran. Methods: Required data were drawn from two Iran’s demographic and health survey (DHS) conducted in 2000 and 2010. Normalized concentration index (CI) was used to measure the magnitude of inequality in neonatal mortality. The contribution of various determinants to inequality was estimated by decomposing concentration indices in 1995-2000 and 2005-2010. Finally, changes in inequality were investigated using Oaxaca-type decomposition technique. Results: Pro-rich inequality in neonatal mortality was declined by 16%, ie, the normalized CI dropped from -0.1490 in 1995-2000 to -0.1254 in 2005-2010. The largest contribution to inequality was attributable to mother’s education (32%) and household’s economic status (49%) in 1995-2000 and 2005-2010, respectively. Changes in mother’s educational level (121%), use of skilled birth attendants (79%), mother’s age at the delivery time (25-34 years old) (54%) and using modern contraceptive (29%) were mainly accountable for the decrease in inequality in neonatal mortality. Conclusion: Policy actions on improving households’ economic status and maternal education, especially in rural areas, may have led to the reduction in neonatal mortality inequality in Iran. PMID:28812805

Intended and Unintended Consequences of Educational Technology on Social Inequality

ERIC Educational Resources Information Center

Tawfik, Andrew A.; Reeves, Todd D.; Stich, Amy

2016-01-01

While much has been written in the field of educational technology regarding educational excellence and efficiency, less attention has been paid to issues of equity. Along these lines, the field of educational technology often does not address key equity problems such as academic achievement and attainment gaps, and inequality of educational…

Tackling Social Inequality and Exclusion in Education: From Human Capital to Capabilities

ERIC Educational Resources Information Center

Vandekinderen, Caroline; Roets, Griet; Van Keer, Hilde; Roose, Rudi

2018-01-01

Both in the international context and in Flanders (the Dutch-speaking part of Belgium), research shows that many young people experience social exclusion in relation to education. However, research evidence concerning structural social inequality in education is predominantly underpinned by an outcome-based approach, since educational policies and…

Education, Horizontal Inequalities and Ethnic Relations in Nigeria

ERIC Educational Resources Information Center

Ukiwo, Ukoha

2007-01-01

The article focuses on the role of higher education in generating or mitigating inequality among ethno-regional groups and its impact on ethnic relations with evidence from Nigeria. It shows that access to education in Nigeria has been politicised. This is because of the perceived role of education in engendering political and socio-economic…

Income inequality and the developing child: Is it all relative?

PubMed

Odgers, Candice L

2015-11-01

Children from low-income families are at heightened risk for a number of poor outcomes, including depression, antisocial behavior, poor physical health, and educational failure. Growing up in poverty is generally seen as toxic for children. However, less is known about how the "economic distance" between children and their peers influences behavior and health. This article examines how both poverty and the growing divide between low-income children and their peers may be influencing low-income children's life chances. Among wealthy nations, children in countries with higher levels of income inequality consistently fare worse on multiple indices of health, educational attainment, and well-being. New research also suggests that low-income children may be experiencing worse outcomes, and a form of "double disadvantage," when they live and attend school alongside more affluent versus similarly positioned peers. The role of subjective social status in explaining why some low-income children appear to suffer when growing up alongside more affluent peers is explored, alongside a call for additional research focused on how children come to understand, and respond to, their perceived social status. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Trends in Educational Inequalities in Drug Poisoning Mortality: United States, 1994-2010.

PubMed

Richardson, Robin; Charters, Thomas; King, Nicholas; Harper, Sam

2015-09-01

We estimated trends in drug poisoning death rates by educational attainment and investigated educational inequalities in drug poisoning mortality by race, gender, and region. We linked drug poisoning death counts from the National Vital Statistics System to population denominators from the Current Population Survey to estimate drug poisoning rates by gender, race, region, and educational attainment (less than high school degree, high school degree, some college, college degree) from 1994 to 2010. There were 372,485 drug poisoning deaths. Education-related inequalities increased during the study among all demographic groups and varied by region. Absolute increases in educational inequalities were higher among Whites than Blacks and men than women. The age-adjusted rate difference between White men with less than a high school degree increased from 8.7 per 100,000 in 1994 to 27.4 in 2010 (change = 18.7). Among Black men, the corresponding increases were 11.7 and 18.3, respectively (change = 6.6). We found strong educational patterning in drug poisoning rates, chiefly by region and race. Rates are highest and increasing the fastest among groups with less education.

Educational inequalities in mortality and associated risk factors: German--versus French-speaking Switzerland.

PubMed

Faeh, David; Bopp, Matthias

2010-09-22

Between the French- and German-speaking areas of Switzerland, there are distinct differences in mortality, similar to those between Germany and France. Assessing corresponding inequalities may elucidate variations in mortality and risk factors, thereby uncovering public health potential. Our aim was to analyze educational inequalities in all-cause and cause-specific mortality in the two Swiss regions and to compare this with inequalities in behavioural risk factors and self-rated health. The Swiss National Cohort, a longitudinal census-based record linkage study, provided mortality and survival time data (3.5 million individuals, 40-79 years, 261,314 deaths, 1990-2000). The Swiss Health Survey 1992/93 provided cross-sectional data on risk factors. Inequalities were calculated as percentage of change in mortality rate (survival time, hazard ratio) or risk factor prevalence (odds ratio) per year of additional education using multivariable Cox and logistic regression. Significant inequalities in mortality were found for all causes of death in men and for most causes in women. Inequalities were largest in men for causes related to smoking and alcohol use and in women for circulatory diseases. Gradients in all-cause mortality were more pronounced in younger and middle-aged men, especially in German-speaking Switzerland. Mortality inequalities tended to be larger in German-speaking Switzerland whereas inequalities in associated risk factors were generally more pronounced in French-speaking Switzerland. With respect to inequalities in mortality and associated risk factors, we found characteristic differences between German- and French-speaking Switzerland, some of which followed gradients described in Europe. These differences only partially reflected inequalities in associated risk factors.

Sex- and age- specific relations between economic development, economic inequality and homicide rates in people aged 0-24 years: a cross-sectional analysis.

PubMed

Butchart, Alexander; Engström, Karin

2002-01-01

To test whether relations between economic development, economic inequality, and child and youth homicide rates are sex- and age-specific, and whether a country's wealth modifies the impact of economic inequality on homicide rates. Outcome variables were homicide rates around 1994 in males and females in the age ranges 0-4, 5-9, 10-14, 15-19 and 20-24 years from 61 countries. Predictor variables were per capita gross domestic product (GDP), GINI coefficient, percentage change in per capita gross national product (GNP) and female economic activity as a percentage of male economic activity. Relations were analysed by ordinary least squares regression. All predictors explained significant variances in homicide rates in those aged 15-24. Associations were stronger for males than females and weak for children aged 0-9. Models that included female economic inequality and percentage change in GNP increased the effect in children aged 0-9 and the explained variance in females aged 20-24. For children aged 0-4, country clustering by income increased the explained variance for both sexes. For males aged 15-24, the association with economic inequality was strong in countries with low incomes and weak in those with high incomes. Relations between economic factors and child and youth homicide rates varied with age and sex. Interventions to target economic factors would have the strongest impact on rates of homicide in young adults and late adolescent males. In societies with high economic inequality, redistributing wealth without increasing per capita GDP would reduce homicide rates less than redistributions linked with overall economic development.

Sex- and age- specific relations between economic development, economic inequality and homicide rates in people aged 0-24 years: a cross-sectional analysis.

PubMed Central

Butchart, Alexander; Engström, Karin

2002-01-01

OBJECTIVE: To test whether relations between economic development, economic inequality, and child and youth homicide rates are sex- and age-specific, and whether a country's wealth modifies the impact of economic inequality on homicide rates. METHODS: Outcome variables were homicide rates around 1994 in males and females in the age ranges 0-4, 5-9, 10-14, 15-19 and 20-24 years from 61 countries. Predictor variables were per capita gross domestic product (GDP), GINI coefficient, percentage change in per capita gross national product (GNP) and female economic activity as a percentage of male economic activity. Relations were analysed by ordinary least squares regression. FINDINGS: All predictors explained significant variances in homicide rates in those aged 15-24. Associations were stronger for males than females and weak for children aged 0-9. Models that included female economic inequality and percentage change in GNP increased the effect in children aged 0-9 and the explained variance in females aged 20-24. For children aged 0-4, country clustering by income increased the explained variance for both sexes. For males aged 15-24, the association with economic inequality was strong in countries with low incomes and weak in those with high incomes. CONCLUSION: Relations between economic factors and child and youth homicide rates varied with age and sex. Interventions to target economic factors would have the strongest impact on rates of homicide in young adults and late adolescent males. In societies with high economic inequality, redistributing wealth without increasing per capita GDP would reduce homicide rates less than redistributions linked with overall economic development. PMID:12471400

Absolute and Relative Socioeconomic Health Inequalities across Age Groups

PubMed Central

van Zon, Sander K. R.; Bültmann, Ute; Mendes de Leon, Carlos F.; Reijneveld, Sijmen A.

2015-01-01

Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender. Methods The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender. Results Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups. Conclusions Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of socioeconomic position and health outcome, as findings on socioeconomic health inequalities may differ between them. PMID:26717482

Educational Stratification in Russia during the Soviet Period.

ERIC Educational Resources Information Center

Gerber, Theodore P.; Hout, Michael

1995-01-01

Maintains that, in spite of state efforts to reduce educational inequities, stratification actually increased during the Soviet period. Removing gender preferences for men corrected some inequity. However, parents' education, occupation, and geographical origin contributed to the stratification. Contains a concise history of Soviet educational…

A "Dui Hua" (Chinese characters omitted) Standpoint to Multilingual Educational Theorizing

ERIC Educational Resources Information Center

Shen, Haibo

2017-01-01

New forms of intellectual inequality have become evident with the internationalisation of higher degree researchers (HDRs) education, in particular theoretical dominance and dependency. However, the linguistically and theoretically based inequalities associated with local/global currents of standardized monolingual English HDRs education are…

Ethnicity, Inequality, and Higher Education in Malaysia.

ERIC Educational Resources Information Center

Selvaratnam, Viswanathan

1988-01-01

Traces the development since 1957 of Malaysian education policies aimed at providing equitable access to higher education. Suggests that these policies have increased representation of the Malay underclass in tertiary institutions and the professions, but have had little effect on intraethnic class inequalities. 46 references. (SV)

Measuring Education Inequalities: Concentration and Dispersion-Based Approach. Lessons from Kuznets Curve in MENA Region

ERIC Educational Resources Information Center

Ibourk, Aomar; Amaghouss, Jabrane

2012-01-01

Although the quantity of education is widely used to measure the economical and social performances of educative systems, only a few works have addressed the issue of equity in education. In this work, we have calculated two measures of inequality in education based on Barro and Lee's (2010) data: the Gini index of education and the standard…

Ethnicity, Forms of Capital, and Educational Achievement

NASA Astrophysics Data System (ADS)

Driessen, Geert W. J. M.

2001-11-01

Bourdieu's cultural capital thesis is an attempt to explain how social class influences the transmission of educational inequality. In this article, the question of the extent to which various forms of capital also apply to ethnic minorities stands central. On the basis of Dutch and American research findings, a model is formulated and empirically tested with the aid of data from the Dutch Primary Education cohort study. Students from four ethnic groups are included: Dutch, Surinamese, Turkish, and Moroccan. The main variables are language and math test scores, socio-economic milieu, and a number of capital indicators, including financial resources, linguistic resources, parental reading behavior, and educational resources within the family. The results show no mediating effect of resources within the various ethnic groups. The findings also suggest that in research and practice it is relevant to not treat ethnic groups as one homogenous group, but to differentiate between the various groups.

Is educational differentiation associated with smoking and smoking inequalities in adolescence? A multilevel analysis across 27 European and North American countries.

PubMed

Rathmann, Katharina; Moor, Irene; Kunst, Anton E; Dragano, Nico; Pförtner, Timo-Kolja; Elgar, Frank J; Hurrelmann, Klaus; Kannas, Lasse; Baška, Tibor; Richter, Matthias

2016-09-01

This study aims to determine whether educational differentiation (i.e. early and long tracking to different school types) relate to socioeconomic inequalities in adolescent smoking. Data were collected from the WHO-Collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, which included 48,025 15-year-old students (Nboys = 23,008, Ngirls = 25,017) from 27 European and North American countries. Socioeconomic position was measured using the HBSC family affluence scale. Educational differentiation was determined by the number of different school types, age of selection, and length of differentiated curriculum at the country-level. We used multilevel logistic regression to assess the association of daily smoking and early smoking initiation predicted by family affluence, educational differentiation, and their interactions. Socioeconomic inequalities in both smoking outcomes were larger in countries that are characterised by a lower degree of educational differentiation (e.g. Canada, Scandinavia and the United Kingdom) than in countries with higher levels of educational differentiation (e.g. Austria, Belgium, Hungary and The Netherlands). This study found that high educational differentiation does not relate to greater relative inequalities in smoking. Features of educational systems are important to consider as they are related to overall prevalence in smoking and smoking inequalities in adolescence. © 2016 Foundation for the Sociology of Health & Illness.

Eliminating Educational Inequality through E-Learning: The Case of Virtual University of Pakistan

ERIC Educational Resources Information Center

Din, Aisha Muhammad; Jabeen, Sadia

2014-01-01

This study aims at examining the role of e-learning in combating the issues of inequality in terms of access and quality in the field of higher education in Pakistan. The education system in Pakistan is mainly characterized by educational disparity. The standard of education is directly proportional to the investment students make in the form of…

Educational Inequalities and the Expansion of Postsecondary Education in Brazil, from 1982 to 2006

ERIC Educational Resources Information Center

Collares, Ana Cristina Murta

2010-01-01

Brazil has experienced a broad expansion of education in the last few decades, but inequalities in educational access are still high for people of different socioeconomic statuses as well as by gender and race. Using data that covers higher education expansion from 1982 to 2006 in Brazil, this dissertation investigates the consequences of this…

Equity in health and health care in Peru, 2004-2008.

PubMed

Petrera, Margarita; Valdivia, Martín; Jimenez, Eduardo; Almeida, Gisele

2013-02-01

This study evaluates whether recent positive economic trends and pro-poor health policies have resulted in more health equity and explores key factors that explain such change. This study focuses on the evolution of measures of health status (self-reported morbidity) and use of health care services obtained from the 2004 and 2008 rounds of the Peruvian National Household Survey (Encuesta Nacional de Hogares). It concentrates on health inequalities associated with socioeconomic status and uses interquintile differences (gradient), concentration indices with and without needs-based adjustments, and decomposition analysis. Findings show a low level of inequality in measures of health status, with a slightly pro-poor inequality in self-reported health problems and a slightly pro-rich inequality in self-reported chronic illness. Inequity in the use of curative services declined significantly between 2004 and 2008, while inequity in the use of preventive services increased slightly. Use of hospital and dental services remained unchanged during the same period. Limitations of self-reported morbidity measures probably underestimate the results of health inequalities across socioeconomic groups. Improved equity in the use of curative health services can be explained by a number of positive factors that occurred concurrently during the analysis-namely, increased mean household income, reduced economic inequality, the Juntos conditional cash transfer program, and gradual expansion of public health insurance, Seguro Integral de Salud (SIS). Given that SIS expansion is the main public policy for promoting health equity in Peru, it is crucial that future steps in expansion come with a strategy to isolate its contribution to health equity improvements from that of other positive socioeconomic trends.

Principles of Lifeworld Led Public Health Practice in the UK and Sweden: Reducing Health Inequalities

PubMed Central

Hemingway, Ann; Norton, Liz; Aarts, Clara

2015-01-01

The purpose of this paper is to consider the role of the lifeworld perspective in reducing inequalities in health and we explain how the public health practitioner can use this perspective to address public health issues with individuals and groups. We offer ideas for public health actions that are based on and deal with the lifeworld context of individual people or families. Each of the dimensions of the lifeworld temporality, spatiality, intersubjectivity, embodiment and mood are outlined and their significance explained in relation to health inequalities. Suggestions for action to reduce health inequalities are made and overall principles of lifeworld led public health practice are proposed by way of conclusion. The principles comprise understanding the community members' lifeworld view, understanding their view of their potential, offering resources and facilitating empowerment, and sharing lifeworld case studies and lobbying to influence local and national policy in relation to both the individual and communities. PMID:25642346

Bernstein in the Urban Classroom: A Case Study

ERIC Educational Resources Information Center

Barrett, Brian D.

2017-01-01

Despite a long-standing concern within the sociology of education for ameliorating educational inequality, the challenge of improving educational opportunities for disadvantaged students remains deeply entrenched. While 'macro' issues such as segregation and systemic inequalities in school funding and access to qualified teachers must be addressed…

Educators as "Equity Warriors." CEPA Working Paper No. 17-11

ERIC Educational Resources Information Center

Rochmes, Jane; Penner, Emily; Loeb, Susanna

2017-01-01

Despite the multifaceted causes of educational disparities, schools' responsibility for reducing inequality undergirds American ideals. Educators operate as street-level bureaucrats to accomplish this equalizing work. Surprisingly, we know little about how teachers think about inequality or enact strategies to combat it, even though their…

Interrogating Institutionalized Establishments: Urban-Rural Inequalities in China's Higher Education

ERIC Educational Resources Information Center

Li, Mei; Yang, Rui

2013-01-01

China's urban-rural disparities are a fundamental source of China's overall educational inequalities. This article addresses the issue with data collected through interviews with members at various Chinese higher education institutions. It interrogates China's current policies together with the socio-political institutional arrangements that…

Higher Education and Inequality

ERIC Educational Resources Information Center

Brown, Roger

2018-01-01

After climate change, rising economic inequality is the greatest challenge facing the advanced Western societies. Higher education has traditionally been seen as a means to greater equality through its role in promoting social mobility. But with increased marketisation higher education now not only reflects the forces making for greater inequality…

Educational differences in responses to breast cancer symptoms: A qualitative comparative study.

PubMed

Marcu, Afrodita; Black, Georgia; Vedsted, Peter; Lyratzopoulos, Georgios; Whitaker, Katriina L

2017-02-01

Advanced stage at diagnosis for breast cancer is associated with lower socio-economic status (SES). We explored what factors in the patient interval (time from noticing a bodily change to first consultation with a health care professional) may contribute to this inequality. Qualitative comparative study. Semi-structured interviews with a sample of women (≥47 years) from higher (n = 15) and lower (n = 15) educational backgrounds, who had experienced at least one potential breast cancer symptom. Half the participants (n = 15) had sought medical help, half had not (n = 15). Without making breast cancer explicit, we elicited women's sense-making around their symptoms and help-seeking decisions. Containment of symptoms and confidence in acting upon symptoms emerged as two broad themes that differentiated lower and higher educational groups. Women from lower educational backgrounds tended to attribute their breast symptoms to trivial factors and were reticent in using the word 'cancer'. Despite 'knowing' that symptoms could be related to cancer, women with lower education invoked lack of medical knowledge - 'I am not a doctor' - to express uncertainty about interpreting symptoms and accessing help. Women with higher education were confident about interpreting symptoms, seeking information online, and seeking medical help. Our findings suggest that knowledge of breast cancer alone may not explain socio-economic differences in how women respond to breast cancer symptoms as women with lower education had 'reasons' not to react. Research is needed on how to overcome a wider spectrum of psycho-social factors to reduce future inequality. Statement of contribution What is already known on this subject? Seven of ten breast cancers in the UK are diagnosed after people contact their doctor with symptoms. Women from lower socio-economic backgrounds are more likely to be diagnosed with advanced disease. There is little evidence related to potential drivers of this SES inequality. What does this study add? We qualitatively explored socio-economic (SES) differences in help-seeking for breast symptoms. Women with higher education were more confident about interpreting symptoms and navigating health care. Women with lower education were more reluctant to seek help due to fear of cancer. © 2016 The British Psychological Society.

Inequality in Human Capital and Endogenous Credit Constraints

PubMed Central

Hai, Rong; Heckman, James J.

2017-01-01

This paper investigates the determinants of inequality in human capital with an emphasis on the role of the credit constraints. We develop and estimate a model in which individuals face uninsured human capital risks and invest in education, acquire work experience, accumulate assets and smooth consumption. Agents can borrow from the private lending market and from government student loan programs. The private market credit limit is explicitly derived by extending the natural borrowing limit of Aiyagari (1994) to incorporate endogenous labor supply, human capital accumulation, psychic costs of working, and age. We quantify the effects of cognitive ability, noncognitive ability, parental education, and parental wealth on educational attainment, wages, and consumption. We conduct counterfactual experiments with respect to tuition subsidies and enhanced student loan limits and evaluate their effects on educational attainment and inequality. We compare the performance of our model with an influential ad hoc model in the literature with education-specific fixed loan limits. We find evidence of substantial life cycle credit constraints that affect human capital accumulation and inequality. The constrained fall into two groups: those who are permanently poor over their lifetimes and a group of well-endowed individuals with rising high levels of acquired skills who are constrained early in their life cycles. Equalizing cognitive and noncognitive ability has dramatic effects on inequality. Equalizing parental backgrounds has much weaker effects. Tuition costs have weak effects on inequality. PMID:28642641

Inequality in Human Capital and Endogenous Credit Constraints.

PubMed

Hai, Rong; Heckman, James J

2017-04-01

This paper investigates the determinants of inequality in human capital with an emphasis on the role of the credit constraints. We develop and estimate a model in which individuals face uninsured human capital risks and invest in education, acquire work experience, accumulate assets and smooth consumption. Agents can borrow from the private lending market and from government student loan programs. The private market credit limit is explicitly derived by extending the natural borrowing limit of Aiyagari (1994) to incorporate endogenous labor supply, human capital accumulation, psychic costs of working, and age. We quantify the effects of cognitive ability, noncognitive ability, parental education, and parental wealth on educational attainment, wages, and consumption. We conduct counterfactual experiments with respect to tuition subsidies and enhanced student loan limits and evaluate their effects on educational attainment and inequality. We compare the performance of our model with an influential ad hoc model in the literature with education-specific fixed loan limits. We find evidence of substantial life cycle credit constraints that affect human capital accumulation and inequality. The constrained fall into two groups: those who are permanently poor over their lifetimes and a group of well-endowed individuals with rising high levels of acquired skills who are constrained early in their life cycles. Equalizing cognitive and noncognitive ability has dramatic effects on inequality. Equalizing parental backgrounds has much weaker effects. Tuition costs have weak effects on inequality.

Relative contribution of health-related behaviours and chronic diseases to the socioeconomic patterning of low-grade inflammation.

PubMed

Bonaccio, Marialaura; Di Castelnuovo, Augusto; Pounis, George; De Curtis, Amalia; Costanzo, Simona; Persichillo, Mariarosaria; Cerletti, Chiara; Donati, Maria Benedetta; de Gaetano, Giovanni; Iacoviello, Licia

2017-06-01

To test the association of low-grade inflammation with socioeconomic status (SES) and determine the relative contribution of prevalent chronic diseases and health-related behaviours in explaining such association. Cross-sectional analysis on 19,867 subjects (age ≥35, 48.1% men) recruited within the Moli-sani study from 2005 to 2010 (Italy). A score of low-grade inflammation, including platelet and leukocyte counts, the granulocyte-to-lymphocyte ratio, and C-reactive protein was applied. SES was measured by education, household income, and occupational social class. Low SES was associated with elevated levels of low-grade inflammation. Health behaviours (including adiposity, smoking, physical activity, and Mediterranean diet adherence) explained 53.5, 53.9, and 84.9% of the association between social class, income, and education with low-grade inflammation, respectively. Adiposity and body mass index showed a prominent role, while prevalent chronic diseases and conditions only marginally attenuated SES inequalities in inflammation. Low-grade inflammation was socioeconomically patterned in a large Mediterranean population. Potentially modifiable behavioural factors explained the greatest part of this association with a leading contribution of adiposity, body mass index, and physical activity.

Factors other than risks in the workplace as determinants of socioeconomic differences in health in Italy.

PubMed

Mamo, Carlo; Marinacci, Chiara; Demaria, Moreno; Mirabelli, Dario; Costa, Giuseppe

2005-01-01

To evaluate differences in mortality by social class and to determine the impacts of socioeconomic factors on health inequalities in Italy, mortality data from 1981-2001 were analyzed as a function of social class in Turin, controlling for occupational risks, housing conditions, and education. For general and cause-specific mortality, the weight of each socioeconomic indicator was evaluated on population-attributable fraction to social class. Among men, mortality risk was significantly higher in unskilled blue-collar workers (RR = 1.45). Among women, the differences by social class were slighter. Education and economic status mostly explain the mortality differences by social class in men, while economic status showed the highest contribution in women.

Sozialindex und gewichtenregeling . Berücksichtigung von sozialräumlichen Rahmenbedingungen bei der Mittelvergabe an Schulen am Beispiel Nordrhein-Westfalens und den Niederlanden

NASA Astrophysics Data System (ADS)

Terpoorten, Tobias

2016-12-01

In Germany and the Netherlands spatial information about the social structure of the inhabitants is used for the coordination of financial and human resources in the local school-system. The aim is to reduce educational inequalities by taking the social context of the schools into account. The article explains two approaches. In North Rhine-Westphalia (Germany) a so called Sozialindex is used to distribute additional teachers to municipalities with difficult social surroundings. The Dutch government uses an instrument to give each pupil a weight (gewichtenregeling) depending on the specific educational background. Combined with an evaluation of the school location an additional budget, if necessary, will be payed.

Socioeconomic position and survival after lung cancer: Influence of stage, treatment and comorbidity among Danish patients with lung cancer diagnosed in 2004-2010.

PubMed

Dalton, Susanne O; Steding-Jessen, Marianne; Jakobsen, Erik; Mellemgaard, Anders; Østerlind, Kell; Schüz, Joachim; Johansen, Christoffer

2015-05-01

To address social inequality in survival after lung cancer, it is important to consider how socioeconomic position (SEP) influences prognosis. We investigated whether SEP influenced receipt of first-line treatment and whether socioeconomic differences in survival could be explained by differences in stage, treatment and comorbidity. In the Danish Lung Cancer Register, we identified 13 045 patients with lung cancer diagnosed in 2004-2010, with information on stage, histology, performance status and first-line treatment. We obtained age, gender, vital status, comorbid conditions and socioeconomic information (education, income and cohabitation status) from nationwide population-based registers. Associations between SEP and receipt of first-line treatment were analysed in multivariate logistic regression models and those with overall mortality in Cox regression models with stepwise inclusion of possible mediators. For both low- and high-stage lung cancer, adjusted ORs for first-line treatment were reduced in patients with short education and low income, although the OR for education did not reach statistical significance in men with high-stage disease. Patients with high-stage disease who lived alone were less likely to receive first-line treatment. The socioeconomic difference in overall survival was partly explained by differences in stage, treatment and comorbidity, although some differences remained after adjustment. Among patients with high-stage disease, the hazard ratio (HR) for death of those with low income was 1.12 (95% CI 1.05-1.19) in comparison with those with high income. Among patients with low-stage disease, those who lived alone had a 14% higher risk for dying (95% CI 1.05-1.25) than those who lived with a partner. The differences in risk for death by SEP were greatest in the first six months after diagnosis. Socioeconomic differences in survival after lung cancer are partly explained by social inequality in stage, first-line treatment and comorbidity. Efforts should be made to improve early diagnosis and adherence to first-line treatment recommendations among disadvantaged lung cancer patients.

[Mental income inequality: a "virus" which affects health and happiness].

PubMed

Bouffard, Léandre; Dubé, Micheline

2013-01-01

The purpose of this paper is to demonstrate the impact of income inequality on various indexes of mental health and on happiness in wealthy nations. Initially, the unequal distribution of income is documented in wealthy nations, especially in the United States of America. After the World War II, income equality was at a level never reached before, but since the eighties, income inequality has raised dramatically in many industrialized countries. The 2008 crisis has worsened the situation in many of them, particularly in the United States. Furthermore, prejudices have increased against women, Blacks, Spanish-speakers and those who receive social welfare. A selective review of the literature is made in order to document the impact of income inequality on a few indicators of mental health (from WHO, UN, UNICEF, OCDE and World Bank) and on happiness, defined here as life satisfaction. Income inequality is positively related to the following indexes: Index of Mental Illness from the WHO (0.73), Index of the United Nations' Office on Drug Consumption (0.63) and a composite Index of ten psychosocial problems, constituted by Wilkinson and Pickett, 2013 (0.87). On the other hand, income inequality is negatively associated to the UNICEF Index of Child Well-Being (-0.71). Furthermore, the level of anxiety and of depression is higher in countries where income inequality is greater. The correlation between happiness and income inequality in the 23 wealthy nations is -0.48; this correlation becomes -0.41 after control of the effect of the GNP (Gross National Product). These results support the idea that it is relative income - not absolute income - which matters in the evaluation of our life and of our happiness. In underdeveloped nations, any increase in GNP promotes the well-being of the citizens; whereas in wealthy nations, it is the equality of the distribution that is more important. Many arguments supporting the causal relation from income inequality to psychosocial problems and unhappiness are presented. In reality, this income inequality is like a "virus" which affects the well-being of the entire population. Even if the increase of mental problems may be explained by many factors - historical, cultural, ethnic, social, and societal - these factors do not eliminate the effect of income inequality. In order to counter the effects of income inequality and to promote a "flourishing" mental health, the professionals of human sciences are invited to take into account this reality in the implementation of their interventions and to participate to the elaboration of social politics as well as in the education process of the general population.

Sociology of Education: Outlines towards a Diagnosis and Thoughts on Some Major Challenges

ERIC Educational Resources Information Center

Baeck, Unn-Doris Karlsen

2012-01-01

Sociology of education in Norway has traditionally been preoccupied with the classic problems related to education and the reproduction of social inequality. As the general social scientific and political focus on inequality decreased, the sociology of education also became less visible. At the same time, the sociology of youth evolved, and…

Education Rights, Education Policies and Inequality in South Africa

ERIC Educational Resources Information Center

Spreen, Carol Anne; Vally, Salim

2006-01-01

In this article we explore education policy changes in South Africa through a rights-based framework. We situate our analysis in the context of deepening poverty and inequality arguing that progress (or the lack thereof) in schools cannot be divorced from poverty and its consequences. We show that education reform in South Africa has been situated…

[Significant Issues in Education - Law.] Inequality in Education, Number 17, June 1974.

ERIC Educational Resources Information Center

Hall, Leon; And Others

This issue of Inequality in Education deviates from the usual format of in-depth discussion of a particular topic to include reports on a variety of significant issues in education-law. Leon Hall summarizes the numerous experiences he has had with Southern desegregated schools and students and relates his conclusions about how desegregation is…

Education and Inequality in India: A Classroom View. Routledge Contemporary South Asia Series

ERIC Educational Resources Information Center

Majumdar, Manabi; Mooij, Jos

2011-01-01

Universalization of primary education has been high on the policy agenda in India. This book looks at the reproduction of social inequalities within the educational system in India, and how this is contested in different ways. It examines whether the concept of "education for all" is just a mechanically conceived policy target to chasing…

Discovering Social Inequality: Dutch Educational Research in the Post-War Era

ERIC Educational Resources Information Center

Bakker, Nelleke; Amsing, Hilda T. A.

2012-01-01

Between the 1940s and 1960s across Western Europe a spirit of reform along comprehensive lines manifested itself in secondary education, aiming at a reduction of the existing social inequality of educational chances. These reforms are said to be rooted in new policies and in new approaches in educational studies. This article explores the…

Inclusive Education and Social Inequality: An Update of the Question and Some Geographical Considerations

ERIC Educational Resources Information Center

Rambla, Xavier; Ferrer, Ferran; Tarabini, Aina; Verger, Antoni

2008-01-01

The aim of this article is to review the current state of inclusive education in the world and to suggest a few relevant considerations. The first section "Two parallel concerns" retraces the inescapable connections between the educational aspects of inclusive education and more general concerns regarding inequality. The second section "Inclusive…

Trends in Global Gender Inequality

ERIC Educational Resources Information Center

Dorius, Shawn F.; Firebaugh, Glenn

2010-01-01

This study investigates trends in gender inequality throughout the world. Using data encompassing a large majority of the world's population, we examine trends in recent decades for key indicators of gender inequality in education, mortality, political representation and economic activity. We find that gender inequality is declining in virtually…

The Contribution of Smoking to Educational Gradients in U.S. Life Expectancy*

PubMed Central

Ho, Jessica Y.; Fenelon, Andrew

2014-01-01

Researchers have documented widening educational gradients in mortality in the United States since the 1970s. While smoking has been proposed as a key explanation for this trend, no prior study has quantified the contribution of smoking to increasing education gaps in longevity. We estimate the contribution of smoking to educational gradients in life expectancy using data on white men and women aged 50 and above from the National Longitudinal Mortality Study (N=283,430; 68,644 deaths) and the National Health Interview Survey (N=584,811; 127,226 deaths) in five periods covering the 1980s to 2006. In each period, smoking makes an important contribution to education gaps in longevity for white men and women. Smoking accounts for half the increase in the gap for white women but does not explain the widening gap for white men in the most recent period. Addressing greater initiation and continued smoking among the less educated may reduce mortality inequalities. PMID:26199287

Tobacco Control Measures to Reduce Socioeconomic Inequality in Smoking: The Necessity, Time-Course Perspective, and Future Implications.

PubMed

Tabuchi, Takahiro; Iso, Hiroyasu; Brunner, Eric

2018-04-05

Previous systematic reviews of population-level tobacco control interventions and their effects on smoking inequality by socioeconomic factors concluded that tobacco taxation reduce smoking inequality by income (although this is not consistent for other socioeconomic factors, such as education). Inconsistent results have been reported for socioeconomic differences, especially for other tobacco control measures, such as smoke-free policies and anti-tobacco media campaigns. To understand smoking inequality itself and to develop strategies to reduce smoking inequality, knowledge of the underlying principles or mechanisms of the inequality over a long time-course may be important. For example, the inverse equity hypothesis recognizes that inequality may evolve in stages. New population-based interventions are initially primarily accessed by the affluent and well-educated, so there is an initial increase in socioeconomic inequality (early stage). These inequalities narrow when the deprived population can access the intervention after the affluent have gained maximum benefit (late stage). Following this hypothesis, all tobacco control measures may have the potential to reduce smoking inequality, if they continue for a long term, covering and reaching all socioeconomic subgroups. Re-evaluation of the impact of the interventions on smoking inequality using a long time-course perspective may lead to a favorable next step in equity effectiveness. Tackling socioeconomic inequality in smoking may be a key public health target for the reduction of inequality in health.

Tobacco Control Measures to Reduce Socioeconomic Inequality in Smoking: The Necessity, Time-Course Perspective, and Future Implications

PubMed Central

Brunner, Eric

2018-01-01

Previous systematic reviews of population-level tobacco control interventions and their effects on smoking inequality by socioeconomic factors concluded that tobacco taxation reduce smoking inequality by income (although this is not consistent for other socioeconomic factors, such as education). Inconsistent results have been reported for socioeconomic differences, especially for other tobacco control measures, such as smoke-free policies and anti-tobacco media campaigns. To understand smoking inequality itself and to develop strategies to reduce smoking inequality, knowledge of the underlying principles or mechanisms of the inequality over a long time-course may be important. For example, the inverse equity hypothesis recognizes that inequality may evolve in stages. New population-based interventions are initially primarily accessed by the affluent and well-educated, so there is an initial increase in socioeconomic inequality (early stage). These inequalities narrow when the deprived population can access the intervention after the affluent have gained maximum benefit (late stage). Following this hypothesis, all tobacco control measures may have the potential to reduce smoking inequality, if they continue for a long term, covering and reaching all socioeconomic subgroups. Re-evaluation of the impact of the interventions on smoking inequality using a long time-course perspective may lead to a favorable next step in equity effectiveness. Tackling socioeconomic inequality in smoking may be a key public health target for the reduction of inequality in health. PMID:29151476

Educational Inequalities among Latin American Adolescents: Continuities and Changes over the 1980s, 1990s and 2000s.

PubMed

Marteleto, Letícia; Gelber, Denisse; Hubert, Celia; Salinas, Viviana

2012-09-01

The goal of this paper is to examine recent trends in educational stratification for Latin American adolescents growing up in three distinct periods: the 1980s, during severe recession; the 1990s, a period of structural adjustments imposed by international organizations; and the late 2000s, when most countries in the region experienced positive and stable growth. In addition to school enrollment and educational transitions, we examine the quality of education through enrollment in private schools, an important aspect of inequality in education that most studies have neglected. We use nationally representative household survey data for the 1980s, 1990s and 2000s in Brazil, Chile, Mexico and Uruguay. Our overall findings confirm the importance of macroeconomic conditions for inequalities in educational opportunity, suggesting important benefits brought up by the favorable conditions of the 2000s. However, our findings also call attention to increasing disadvantages associated with the quality of the education adolescents receive, suggesting the significance of the EMI framework-Effectively Maintained Inequality-and highlighting the value of examining the quality in addition to the quantity of education in order to fully understand educational stratification in the Latin American context.

How education systems shape cross-national ethnic inequality in math competence scores: Moving beyond mean differences.

PubMed

Spörlein, Christoph; Schlueter, Elmar

2018-01-01

Here we examine a conceptualization of immigrant assimilation that is based on the more general notion that distributional differences erode across generations. We explore this idea by reinvestigating the efficiency-equality trade-off hypothesis, which posits that stratified education systems educate students more efficiently at the cost of increasing inequality in overall levels of competence. In the context of ethnic inequality in math achievement, this study explores the extent to which an education system's characteristics are associated with ethnic inequality in terms of both the group means and group variances in achievement. Based on data from the 2012 PISA and mixed-effect location scale models, our analyses revealed two effects: on average, minority students had lower math scores than majority students, and minority students' scores were more concentrated at the lower end of the distribution. However, the ethnic inequality in the distribution of scores declined across generations. We did not find compelling evidence that stratified education systems increase mean differences in competency between minority and majority students. However, our analyses revealed that in countries with early educational tracking, minority students' math scores tended to cluster at the lower end of the distribution, regardless of compositional and school differences between majority and minority students.

How education systems shape cross-national ethnic inequality in math competence scores: Moving beyond mean differences

PubMed Central

Spörlein, Christoph

2018-01-01

Here we examine a conceptualization of immigrant assimilation that is based on the more general notion that distributional differences erode across generations. We explore this idea by reinvestigating the efficiency-equality trade-off hypothesis, which posits that stratified education systems educate students more efficiently at the cost of increasing inequality in overall levels of competence. In the context of ethnic inequality in math achievement, this study explores the extent to which an education system’s characteristics are associated with ethnic inequality in terms of both the group means and group variances in achievement. Based on data from the 2012 PISA and mixed-effect location scale models, our analyses revealed two effects: on average, minority students had lower math scores than majority students, and minority students’ scores were more concentrated at the lower end of the distribution. However, the ethnic inequality in the distribution of scores declined across generations. We did not find compelling evidence that stratified education systems increase mean differences in competency between minority and majority students. However, our analyses revealed that in countries with early educational tracking, minority students’ math scores tended to cluster at the lower end of the distribution, regardless of compositional and school differences between majority and minority students. PMID:29494677

Educational inequalities in hypertension: complex patterns in intersections with gender and race in Brazil.

PubMed

Alves, Ronaldo Fernandes Santos; Faerstein, Eduardo

2016-11-17

Hypertension is a major public health issue worldwide, but knowledge is scarce about its patterns and its relationship to multiple axes of social disadvantages in Latin American countries. This study describes the educational inequality in the prevalence of hypertension in Brazil, including a joint stratification by gender and race. We analyzed interview-based data and blood pressure measurements from 59,402 participants aged 18 years or older at the 2013 Brazilian National Health Survey (PNS). Sociodemographic characteristics analyzed were gender (male, female), racial self-identification (white, brown, black), age (5-years intervals), and educational attainment (pre-primary, primary, secondary, tertiary). Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, and/or self-reported use of antihypertensive medications in the last 2 weeks. We used logistic regression to evaluate the age-adjusted prevalences of hypertension (via marginal modeling), and pair-wise associations between education level and odds of hypertension. Further, the educational inequality in hypertension was summarized through the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). All analyses considered the appropriate sampling weights and intersections with gender, race, and education. Age-adjusted prevalence of hypertension was 34.0 % and 30.8 % among men and women, respectively. Black and brown women had a higher prevalence than whites (34.5 % vs. 31.8 % vs. 29.5 %), whereas no racial differences were observed among men. White and brown, but not black women, showed graded inverse associations between hypertension and educational attainment; among men, non-statistically significant associations were observed in all racial strata. The RII and SII estimated inverse gradients among white (RII = 2.5, SII = 18.1 %) and brown women (RII = 2.3, SII = 14.5 %), and homogeneous distributions of hypertension in educational subgroups among black women and among men. In this representative sample of Brazilian adults, the association between educational attainment and hypertension was influenced by gender and race - a topic still poorly understood. Our findings highlight the importance of assessing intersections of multiple sociodemographic characteristics in health inequalities research. The use of comprehensive measures of inequality, such as RII and SII, provide useful insights for monitoring health inequalities in an intersectional perspective.

Educational Opportunity. The Concept, Its Measurement, and Application. Highlights. Sponsored Reports Series.

ERIC Educational Resources Information Center

National Center for Education Statistics (DHEW), Washington, DC.

Statistical indicators of inequality of educational opportunity developed through this study were applied to 1970 census information concerning school resources and revenues and pupil characteristics to assess the extent of inequality in elementary and secondary schools. Educational equality is defined as the prevailing view that all students…

Impact of Education on the Income of Different Social Groups

ERIC Educational Resources Information Center

Yue, Changjun; Liu, Yanping

2007-01-01

This study investigates, statistically and econometrically, the income level, income inequality, education inequality, and the relationship between education and income of different social groups, on the basis of the Chinese Urban Household Survey conducted in 2005, the Gini coefficient and the quartile regression method. Research findings…

Leading Education beyond What Works

ERIC Educational Resources Information Center

Møller, Jorunn

2017-01-01

Currently, the issue of inequality is one of the most pressing concerns in education and educational research. Factors such as increased socio-economic inequality, movement of people across national boundaries and refugees create major challenges for local communities and schools. Therefore, it is crucial to ensure that teaching and leadership are…

Aspiration Levels and Educational Choices: An Experimental Study

ERIC Educational Resources Information Center

Page, Lionel; Garboua, Louis Levy; Montmarquette, Claude

2007-01-01

The explanation of social inequalities in education is still a debated issue in economics. Recent empirical studies tend to downplay the potential role of credit constraint. This article tests a different potential explanation of social inequalities in education, specifically that social differences in aspiration level result in different…

International Symposium (Madras, India, January 28-February 1, 1980).

ERIC Educational Resources Information Center

Adiseshiah, Malcolm S., Ed.

1980-01-01

The role of adult education in reducing inequalities and raising levels of professional qualifications and cultural standards is the subject of this series of five reports presented at a symposium on adult education and inequality. Discussions of the role of adult education's threefold perspective of literacy learning and general cultural…

Educational Opportunities. Tackling Ethnic, Class and Gender Inequality through Research.

ERIC Educational Resources Information Center

Driessen, Geert, Ed.; Jungbluth, Paul, Ed.

This collection presents a cross section of research into the theme of equal opportunities in education in the Netherlands. The majority of articles are on the Dutch situation, which resembles that of other countries in many respects. Contributions include: (1) "Educational Inequality Research in the Netherlands. Conditions, Constraints and…

Current State of Guangxi Compulsory Education Equity and Countermeasures

ERIC Educational Resources Information Center

Xu, Yuan

2009-01-01

This study maps education inequity in Guangxi province from various perspectives and argues that the inequity generally exists among different areas and different groups within the province. The author then provides some policy suggestions for the government to correct the education imbalances. (Contains 1 table.) [This article was translated by…

Cascading in Higher Education: Investigating the Impact of Institutional Stratification on Educational Opportunity in America

ERIC Educational Resources Information Center

Bastedo, Michael N.; Jaquette, Ozan; Harris, Nathan F.

2009-01-01

Among scholars of social stratification, the most important question about expanding postsecondary education is whether it reduces inequality by creating opportunities for disadvantaged students or whether it increases inequality by concentrating opportunities among those already privileged (Shavit, 2007). This discussion is important because of…

Socioeconomic inequalities and changes in oral health behaviors among Brazilian adolescents from 2009 to 2012

PubMed Central

Freire, Maria do Carmo Matias; Jordão, Lidia Moraes Ribeiro; Malta, Deborah Carvalho; Andrade, Silvânia Suely Caribé de Araújo; Peres, Marco Aurelio

2015-01-01

OBJECTIVE To analyze oral health behaviors changes over time in Brazilian adolescents concerning maternal educational inequalities. METHODS Data from the Pesquisa Nacional de Saúde do Escolar (Brazilian National School Health Survey) were analyzed. The sample was composed of 60,973 and 61,145 students from 26 Brazilian state capitals and the Federal District in 2009 and 2012, respectively. The analyzed factors were oral health behaviors (toothbrushing frequency, sweets consumption, soft drink consumption, and cigarette experimentation) and sociodemographics (age, sex, race, type of school and maternal schooling). Oral health behaviors and sociodemographic factors in the two years were compared (Rao-Scott test) and relative and absolute measures of socioeconomic inequalities in health were estimated (slope index of inequality and relative concentration index), using maternal education as a socioeconomic indicator, expressed in number of years of study (> 11; 9-11; ≤ 8). RESULTS Results from 2012, when compared with those from 2009, for all maternal education categories, showed that the proportion of people with low toothbrushing frequency increased, and that consumption of sweets and soft drinks and cigarette experimentation decreased. In private schools, positive slope index of inequality and relative concentration index indicated higher soft drink consumption in 2012 and higher cigarette experimentation in both years among students who reported greater maternal schooling, with no significant change in inequalities. In public schools, negative slope index of inequality and relative concentration index indicated higher soft drink consumption among students who reported lower maternal schooling in both years, with no significant change overtime. The positive relative concentration index indicated inequality in 2009 for cigarette experimentation, with a higher prevalence among students who reported greater maternal schooling. There were no inequalities for toothbrushing frequency or sweets consumption. CONCLUSIONS There were changes in the prevalences of oral health behaviors during the analyzed period; however, these changes were not related to maternal education inequalities. PMID:26270015

Technological innovations and the rise of social inequalities in health.

PubMed

Weiss, Daniel; Eikemo, Terje Andreas

2017-11-01

Social inequalities in health have been categorised as a human-rights issue that requires action. Unfortunately, these inequalities are on the rise in many countries, including welfare states. Various theories have been offered to explain the persistence (and rise) of these inequalities over time, including the social determinants of health and fundamental cause theory. Interestingly, the rise of modern social inequalities in health has come at a time of great technological innovation. This article addresses whether these technological innovations are significantly influencing the persistence of modern social inequalities in health. A theoretical argument is offered for this potential connection and is discussed alongside the typical social determinants of health perspective and the increasingly popular fundamental cause perspective. This is followed by a proposed research agenda for further investigation of the potential role that technological innovations may play in influencing social inequalities in health.

Does government provision of healthcare explain the relationship between income inequality and low birthweight?

PubMed

Lhila, Aparna

2009-10-01

This paper estimates the relationship between state and county income inequality and low birthweight (LBW) in the U.S. It examines whether more unequal societies are also less healthy because such societies have lower investment in population health. The model includes an extensive list of community and individual controls and community fixed-effects. Results show that unequal states in fact have greater social investments, and absent these investments children born in such states would be more likely to be LBW. Using alternate measures of inequality reveals that income inequality in the upper tail of the income distribution is not related to LBW; but inequality in the lower tail of the income distribution is associated with increased LBW where the supply of healthcare mitigates the effect of income inequality. Consistent with prior findings, county income inequality is not significantly related to LBW.

Education-related inequity in healthcare with heterogeneous reporting of health

PubMed Central

d’Uva, Teresa Bago; Lindeboom, Maarten; O’Donnell, Owen; van Doorslaer, Eddy

2011-01-01

Summary Reliance on self-rated health to proxy medical need can bias estimation of education-related inequity in healthcare utilization. We correct this bias both by instrumenting self-rated health with objective health indicators and by purging self-rated health of reporting heterogeneity that is identified from health vignettes. Using data on elderly Europeans, we find that instrumenting self-rated health shifts the distribution of visits to a doctor in the direction of inequality favouring the better educated. There is a further, and typically larger, shift in the same direction when correction is made for the tendency of the better educated to rate their health more negatively. PMID:21938140

Access to treatment and educational inequalities in cancer survival.

PubMed

Fiva, Jon H; Hægeland, Torbjørn; Rønning, Marte; Syse, Astri

2014-07-01

The public health care systems in the Nordic countries provide high quality care almost free of charge to all citizens. However, social inequalities in health persist. Previous research has, for example, documented substantial educational inequalities in cancer survival. We investigate to what extent this may be driven by differential access to and utilization of high quality treatment options. Quasi-experimental evidence based on the establishment of regional cancer wards indicates that (i) highly educated individuals utilized centralized specialized treatment to a greater extent than less educated patients and (ii) the use of such treatment improved these patients' survival. Copyright © 2014 Elsevier B.V. All rights reserved.

SOCIOECONOMIC INEQUALITIES IN SELF-REPORTED HEALTH AND PHYSICAL FUNCTIONING IN ARGENTINA: FINDINGS FROM THE NATIONAL SURVEY ON QUALITY OF LIFE OF OLDER ADULTS 2012 (ENCaViAM).

PubMed

Rodríguez López, Santiago; Colantonio, Sonia E; Celton, Dora E

2017-09-01

This study aimed to evaluate educational and income inequalities in self-reported health (SRH), and physical functioning (limitations in Activities of Daily Living (ADL)/Instrumental Activities of Daily Living (IADL)), among 60-year-old and older adults in Argentina. Using cross-sectional data from the Argentinian National Survey on Quality of Life of Older Adults 2012 (Encuesta Nacional sobre Calidad de Vida de Adultos Mayores, ENCaViAM), gender-specific socioeconomic inequalities in SRH and ADL and IADL limitations were studied in relation to educational level and household per capita income. The Relative Index of Inequality (RII) - an index of the relative size of socioeconomic inequalities in health - was used. Socioeconomic inequalities in the studied health indicators were found - except for limitations in ADL among women - favouring socially advantaged groups. The results remained largely significant after full adjustment, suggesting that educational and income inequalities, mainly in SRH and IADL, were robust and somehow independent of age, marital status, physical activity, the use of several medications, depression and the occurrence of falls. The findings add to the existing knowledge on the relative size of the socioeconomic inequalities in subjective health indicators among Argentinian older adults, which are to the detriment of lower socioeconomic groups. The results could be used to inform planning interventions aimed at decreasing socioeconomic inequalities in health, to the benefit of socially disadvantaged adults.

Socioeconomic gradient in health in Canada: Is the gap widening or narrowing?

PubMed

Hajizadeh, Mohammad; Mitnitski, Arnold; Rockwood, Kenneth

2016-09-01

Notwithstanding a general improvement in health status, the socioeconomic gradient in health remains a public health challenge worldwide. Using longitudinal data from the National Population Health Survey (NPHS, n=17,276), we examined trends in socioeconomic gradients in two health indicators, viz. the Health Utility Index (HUI) and the Frailty Index (FI), among Canadian adults (25 years and older) between 1998/9-2010/11. The relative and slope indices of inequality (RII and SII, respectively) were employed to summarize income- and education-based inequality in the FI and the HUI in Canada as whole, and in five regions: the Atlantic provinces, Quebec, Ontario, the Prairies and British Columbia. We found that education- and income-related inequalities in health were present in all five regions of Canada. The estimated RIIs and SIIs suggested that education-related inequalities in the FI and the HUI increased among women. The results also revealed that relative and absolute income-related inequalities in the HUI increased in Canada, especially among women. Both absolute and relative inequalities indicated that income-related inequalities in the HUI increased in Quebec and in the Prairies over time. Persistent and growing socioeconomic inequalities in health in Canada over the past one and half decades should warrant more attention. The mechanisms underlying socioeconomic-related inequalities in Canada are less clear. Therefore, further studies are required to identify effective polices to reduce the socioeconomic gradient in health in Canada. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Needs of the Highly Able and the Needs of Society: A Multidisciplinary Analysis of Talent Differentiation and Its Significance to Gifted Education and Issues of Societal Inequality

ERIC Educational Resources Information Center

Persson, Roland S.

2014-01-01

Does gifted education affect societal inequality, and does societal inequality suppress and/or distort the development of high ability? Drawing from several academic disciplines and current political discourse, a differentiated use of terms used to describe the highly able is explored in this article. A social evolutionary framework is proposed as…

Freeing up Teachers to Learn: A Case Study of Teacher Autonomy as a Tool for Reducing Educational Inequalities in a Montessori School

ERIC Educational Resources Information Center

Steiner, Martyn

2016-01-01

A major factor influencing the potential for schools to address inequalities is the freedom that teachers have to reflect and to act to address those inequalities. This article describes how an education system that emphasises the informal and qualitative can leave greater room for teachers to develop themselves and to focus on the direct task of…

Socioeconomic inequality in domains of health: results from the World Health Surveys

PubMed Central

2012-01-01

Background In all countries people of lower socioeconomic status evaluate their health more poorly. Yet in reporting overall health, individuals consider multiple domains that comprise their perceived health state. Considered alone, overall measures of self-reported health mask differences in the domains of health. The aim of this study is to compare and assess socioeconomic inequalities in each of the individual health domains and in a separate measure of overall health. Methods Data on 247,037 adults aged 18 or older were analyzed from 57 countries, drawn from all national income groups, participating in the World Health Survey 2002-2004. The analysis was repeated for lower- and higher-income countries. Prevalence estimates of poor self-rated health (SRH) were calculated for each domain and for overall health according to wealth quintiles and education levels. Relative socioeconomic inequalities in SRH were measured for each of the eight health domains and for overall health, according to wealth quintiles and education levels, using the relative index of inequality (RII). A RII value greater than one indicated greater prevalence of self-reported poor health among populations of lower socioeconomic status, called pro-rich inequality. Results There was a descending gradient in the prevalence of poor health, moving from the poorest wealth quintile to the richest, and moving from the lowest to the highest educated groups. Inequalities which favor groups who are advantaged either with respect to wealth or education, were consistently statistically significant in each of the individual domains of health, and in health overall. However the size of these inequalities differed between health domains. The prevalence of reporting poor health was higher in the lower-income country group. Relative socioeconomic inequalities in the health domains and overall health were higher in the higher-income country group than the lower-income country group. Conclusions Using a common measurement approach, inequalities in health, favoring the rich and the educated, were evident in overall health as well as in every health domain. Existent differences in averages and inequalities in health domains suggest that monitoring should not be limited only to overall health. This study carries important messages for policy-making in regard to tackling inequalities in specific domains of health. Targeting interventions towards individual domains of health such as mobility, self-care and vision, ought to be considered besides improving overall health. PMID:22429978

Trends in inequalities in premature mortality: a study of 3.2 million deaths in 13 European countries.

PubMed

Mackenbach, Johan P; Kulhánová, Ivana; Menvielle, Gwenn; Bopp, Matthias; Borrell, Carme; Costa, Giuseppe; Deboosere, Patrick; Esnaola, Santiago; Kalediene, Ramune; Kovacs, Katalin; Leinsalu, Mall; Martikainen, Pekka; Regidor, Enrique; Rodriguez-Sanz, Maica; Strand, Bjørn Heine; Hoffmann, Rasmus; Eikemo, Terje A; Östergren, Olof; Lundberg, Olle

2015-03-01

Over the last decades of the 20th century, a widening of the gap in death rates between upper and lower socioeconomic groups has been reported for many European countries. For most countries, it is unknown whether this widening has continued into the first decade of the 21st century. We collected and harmonised data on mortality by educational level among men and women aged 30-74 years in all countries with available data: Finland, Sweden, Norway, Denmark, England and Wales, Belgium, France, Switzerland, Spain, Italy, Hungary, Lithuania and Estonia. Relative inequalities in premature mortality increased in most populations in the North, West and East of Europe, but not in the South. This was mostly due to smaller proportional reductions in mortality among the lower than the higher educated, but in the case of Lithuania and Estonia, mortality rose among the lower and declined among the higher educated. Mortality among the lower educated rose in many countries for conditions linked to smoking (lung cancer, women only) and excessive alcohol consumption (liver cirrhosis and external causes). In absolute terms, however, reductions in premature mortality were larger among the lower educated in many countries, mainly due to larger absolute reductions in mortality from cardiovascular disease and cancer (men only). Despite rising levels of education, population-attributable fractions of lower education for mortality rose in many countries. Relative inequalities in premature mortality have continued to rise in most European countries, and since the 1990s, the contrast between the South (with smaller inequalities) and the East (with larger inequalities) has become stronger. While the population impact of these inequalities has further increased, there are also some encouraging signs of larger absolute reductions in mortality among the lower educated in many countries. Reducing inequalities in mortality critically depends upon speeding up mortality declines among the lower educated, and countering mortality increases from conditions linked to smoking and excessive alcohol consumption such as lung cancer, liver cirrhosis and external causes. 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.

Reported consumption of takeaway food and its contribution to socioeconomic inequalities in body mass index.

PubMed

Miura, Kyoko; Turrell, Gavin

2014-03-01

The aim of this study was to examine whether takeaway food consumption mediated (explained) the association between socioeconomic position and body mass index (BMI). A postal-survey was conducted among 1500 randomly selected adults aged between 25 and 64years in Brisbane, Australia during 2009 (response rate 63.7%, N=903). BMI was calculated using self-reported weight and height. Participants reported usual takeaway food consumption, and these takeaway items were categorised into "healthy" and "less healthy" choices. Socioeconomic position was ascertained by education, household income, and occupation. The mean BMI was 27.1kg/m(2) for men and 25.7kg/m(2) for women. Among men, none of the socioeconomic measures were associated with BMI. In contrast, women with diploma/vocational education (β=2.12) and high school only (β=2.60), and those who were white-collar (β=1.55) and blue-collar employees (β=2.83) had significantly greater BMI compared with their more advantaged counterparts. However, household income was not associated with BMI. Among women, the consumption of "less healthy" takeaway food mediated BMI differences between the least and most educated, and between those employed in blue collar occupations and their higher status counterparts. Decreasing the consumption of "less healthy" takeaway options may reduce socioeconomic inequalities in overweight and obesity among women but not men. Copyright © 2013 Elsevier Ltd. All rights reserved.

Pathways of economic inequalities in maternal and child health in urban India: a decomposition analysis.

PubMed

Goli, Srinivas; Doshi, Riddhi; Perianayagam, Arokiasamy

2013-01-01

Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India. Using data from the third wave of the National Family Health Survey (NFHS, 2005-06), this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs), institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR). Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues. The CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI = -0.3501), institutional delivery (CI = -0.3214), children without fully immunization (CI = -0.18340), underweight children (CI = -0.19420), and infant deaths (CI = -0.15596). Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India. Findings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical pathways through which economic factors operate on inequalities in maternal and child health outcomes in urban India.

Pathways of Economic Inequalities in Maternal and Child Health in Urban India: A Decomposition Analysis

PubMed Central

Goli, Srinivas; Doshi, Riddhi; Perianayagam, Arokiasamy

2013-01-01

Background/Objective Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India. Methods Using data from the third wave of the National Family Health Survey (NFHS, 2005–06), this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs), institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR). Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues. Results The CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI  = −0.3501), institutional delivery (CI  = −0.3214), children without fully immunization (CI  = −0.18340), underweight children (CI  = −0.19420), and infant deaths (CI  = −0.15596). Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India. Conclusion Findings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical pathways through which economic factors operate on inequalities in maternal and child health outcomes in urban India. PMID:23555587

Global variance in female population height: the influence of education, income, human development, life expectancy, mortality and gender inequality in 96 nations.

PubMed

Mark, Quentin J

2014-01-01

Human height is a heritable trait that is known to be influenced by environmental factors and general standard of living. Individual and population stature is correlated with health, education and economic achievement. Strong sexual selection pressures for stature have been observed in multiple diverse populations, however; there is significant global variance in gender equality and prohibitions on female mate selection. This paper explores the contribution of general standard of living and gender inequality to the variance in global female population heights. Female population heights of 96 nations were culled from previously published sources and public access databases. Factor analysis with United Nations international data on education rates, life expectancy, incomes, maternal and childhood mortality rates, ratios of gender participation in education and politics, the Human Development Index (HDI) and the Gender Inequality Index (GII) was run. Results indicate that population heights vary more closely with gender inequality than with population health, income or education.

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.

The Education of Girls: Policy, Research and the Question of Gender. Australian Education Review No. 35.

ERIC Educational Resources Information Center

Yates, Lyn

Inequality problems face girls at school, and the attitudes and expectations of others affect educational choices and outcomes. After an overview in chapter 1, chapter 2 provides a discussion of Australian government reports and policies on the education of girls and traces the changes in the treatment of gender inequity. Chapter 3 focuses on the…

Paradoxical Inequalities: Adolescent Peer Relations in Indian Secondary Schools

ERIC Educational Resources Information Center

Milner, Murray, Jr.

2013-01-01

Peer relationships in secondary schools in two different cultural areas of India are compared. A general theory of status relations and a specification of the distinctive cultural features of each area are used to explain the observed differences in peer inequality, clique formation, petty deviance, putdowns, fashion consciousness, romantic…

Gender Inequality in Interaction--An Evolutionary Account

ERIC Educational Resources Information Center

Hopcroft, Rosemary L.

2009-01-01

In this article I argue that evolutionary theorizing can help sociologists and feminists better understand gender inequality. Evolutionary theory explains why control of the sexuality of young women is a priority across most human societies both past and present. Evolutionary psychology has extended our understanding of male violence against…

Educational inequalities in self-rated health: whether post-socialist Estonia and Russia are performing better than 'Scandinavian' Finland.

PubMed

Vöörmann, Rein; Helemäe, Jelena

2015-03-01

The aim of the study is to analyse relationship between self-rated health (SRH) and education in post-socialist countries (Estonia and Russia) and in Finland, a Scandinavian country. Data from the 5th wave of the European Social Survey (ESS) carried out in 2010 were used. In particular, we used a sub-sample of the 25-69 years old. Two-step analysis was carried out: descriptive overview of relationship between SRH and education to assess the knowledge-related impact of education on SRH in pooled model for all three countries; and logistic regression analysis to evaluate separate models in each country. The prevalence of at-least-good health was the highest in Finland, Estonia occupied the second position and Russia the third. Knowledge-related educational inequalities were lower in Russia compared to Finland, while they were of similar magnitude in Estonia and Finland. Our expectations that knowledge-based inequalities are lower in post-socialist countries compared to a Scandinavian country turn to be true in case of Russia, not Estonia. Possible reasons for the expectations might be a lack of attention paid to educational inequalities in terms of access to social resources, competitiveness in the labour market and to what extent education provide a tool against uncertainty (preventing work- and unemployment-related stress). Series of comparative studies revealing links between certain institutional packages and (socio-economic and knowledge-related) educational inequalities seem to be of special relevance.

The role of health-related behavioural factors in accounting for inequalities in coronary heart disease risk by education and area deprivation: prospective study of 1.2 million UK women.

PubMed

Floud, Sarah; Balkwill, Angela; Moser, Kath; Reeves, Gillian K; Green, Jane; Beral, Valerie; Cairns, Benjamin J

2016-10-13

Some recent research has suggested that health-related behaviours, such as smoking, might explain much of the socio-economic inequalities in coronary heart disease (CHD) risk. In a large prospective study of UK women, we investigated the associations between education and area deprivation and CHD risk and assessed the contributions of smoking, alcohol consumption, physical activity and body mass index (BMI) to these inequalities. After excluding women with heart disease, stroke or cancer at recruitment, 1,202,983 women aged 56 years (SD 5 years) on average, were followed for first coronary event (hospital admission or death) and for CHD mortality. Relative risks of CHD were estimated by Cox regression, and the extent to which any association could be accounted for by smoking, alcohol, physical inactivity, and BMI was assessed by calculating the percentage reduction in the relevant likelihood-ratio (LR) statistic after adjustment for these factors, separately and together. A total of 71,897 women had a first CHD event (hospital admission or death) and 6032 died from CHD during 12 years follow-up. In analyses adjusted by age, birth cohort and region of residence only, lower levels of education and greater deprivation were associated with higher risks of CHD (P heterogeneity  < 0.0001 for each); associations for education were found within every level of deprivation and for deprivation were found within every level of education. Smoking, alcohol consumption, physical inactivity and BMI accounted for most of the associations (adjustment for all four factors together reduced the LR statistics for education and for deprivation by 76 % and 71 %, respectively, for first CHD event; and by 87 % and 79 %, respectively, for CHD mortality). Of these four factors, adjustment for smoking resulted in the largest reduction in the LR statistic. Given the large reduction in the predictive values of education and deprivation after adjustment for only four health-related behavioural factors recorded just at recruitment, residual confounding might plausibly account for the remaining associations. Most of the association between CHD risk and education and area deprivation in UK women is accounted for by health-related behaviours, particularly by smoking and to a lesser extent by alcohol consumption, physical inactivity and BMI.

Socioeconomic inequalities in occupational, leisure-time, and transport related physical activity among European adults: A systematic review

PubMed Central

2012-01-01

Background This study systematically reviewed the evidence pertaining to socioeconomic inequalities in different domains of physical activity (PA) by European region. Methods Studies conducted between January 2000 and December 2010 were identified by a systematic search in Pubmed, Embase, Web of Science, Psychinfo, Sportdiscus, Sociological Abstracts, and Social Service Abstracts. English-language peer-reviewed studies undertaken in the general population of adults (18–65 years) were classified by domain of PA (total, leisure-time including sport, occupational, active transport), indicator of socioeconomic position (education, income, occupation), and European region. Distributions of reported positive, negative, and null associations were evaluated. Results A total of 131 studies met the inclusion criteria. Most studies were conducted in Scandinavia (n = 47). Leisure-time PA was the most frequently studied PA outcome (n = 112). Considerable differences in the direction of inequalities were seen for the different domains of PA. Most studies reported that those with high socioeconomic position were more physically active during leisure-time compared to those with low socioeconomic position (68% positive associations for total leisure-time PA, 76% for vigorous leisure-time PA). Occupational PA was more prevalent among the lower socioeconomic groups (63% negative associations). Socioeconomic differences in total PA and active transport PA did not show a consistent pattern (40% and 38% positive associations respectively). Some inequalities differed by European region or socioeconomic indicator, however these differences were not very pronounced. Conclusions The direction of socioeconomic inequalities in PA in Europe differed considerably by domain of PA. The contradictory results for total PA may partly be explained by contrasting socioeconomic patterns for leisure-time PA and occupational PA. PMID:22992350

Societal Projection: Beliefs Concerning the Relationship between Development and Inequality in China

PubMed Central

Xie, Yu; Thornton, Arland; Wang, Guangzhou; Lai, Qing

2012-01-01

We examine how the relationship between development and inequality at the societal level is perceived and evaluated by ordinary Chinese people. We hypothesize that because the Chinese have recently experienced rapid increases in both economic growth and social inequality, they tend to view economic development as a driving force of social inequality. To address this question, we conducted a social survey in 2006 in six Chinese provinces (n = 4,898). The survey data reveal that a large proportion of Chinese people have internalized a causal model in which they project high levels of inequality onto countries they view as more developed and low levels of inequality onto countries they see as less developed. However, results also show that a smaller proportion of Chinese believe in a negative relationship between development and inequality. Hence, the study reveals heterogeneity among ordinary Chinese in their perceptions of the causal relationship between development and inequality. Surprisingly, socioeconomic and demographic characteristics provide no explanatory power in explaining this heterogeneity. PMID:23017918

Self-rated literacy level does not explain educational differences in health and disease

PubMed Central

2014-01-01

Background Although literacy is increasingly considered to play a role in socioeconomic inequalities in health, its contribution to the explanation of educational differences in health has remained unexplored. The aim of this study was to investigate the contribution of self-rated literacy to educational differences in health. Methods Data was collected from the Healthy Foundation and Lifestyle Segmentation Dataset (n = 4257). Self-rated literacy was estimated by individuals’ self-reported confidence in reading written English. We used logistic regression analyses to assess the association between educational level and health (long term conditions and self-rated health). Self-rated literacy and other potential explanatory variables were separately added to each model. For each added variable we calculated the percentage change in odds ratio to assess the contribution to the explanation of educational differences in health. Results People with lower educational attainment level were more likely to report a long term condition (OR 2.04, CI 1.80-2.32). These educational differences could mostly be explained by age (OR decreased by 27%) and could only minimally be explained by self-rated literacy, as measured by self-rated reading skills (OR decreased by 1%). Literacy could not explain differences in cardiovascular condition or diabetes, and only minimally contributed to mental health problems and depression (OR decreased by 5%). The odds of rating ones own health more negatively was higher for people with a low educational level compared to those with a higher educational level (OR 1.83, CI 1.59-2.010), self-rated literacy decreased the OR by 7%. Conclusion Measuring self-rated reading skills does not contribute significantly to the explanation of educational differences in health and disease. Further research should aim for the development of objective generic and specific instruments to measure health literacy skills in the context of health care, disease prevention and health promotion. Such instruments are not only important in the explanation of educational differences in health and disease, but can also be used to identify a group at risk of poorer health through low basic skills, enabling health services and health information to be targeted at those with greater need. PMID:24872884

Explanations of changes in church attendance between 1970 and 2009.

PubMed

van Ingen, Erik; Moor, Nienke

2015-07-01

We deduce hypotheses from theories on religious change to explain changes in church attendance rates. Using a new dataset with 51 countries across a long period we apply panel regression models, which enable us to test well-known theories in a more strict and dynamic fashion than do cross-sectional studies. Our results provide new evidence for a few old ideas, but also show striking lack of evidence for ideas that appear well-accepted. Tertiary education proved to be a strong predictor of changes in church attendance. Theories about individualization were also supported. The evidence of existential insecurity as a cause of change was ambiguous: economic development and life expectancy showed significant effects but income inequality did not. We found no support for theories on social globalization and social benefit policy. Finally, we found that income inequality and urbanization were driving forces of change during the 70s and 80s, but not since 1990. Copyright © 2015 Elsevier Inc. All rights reserved.

When the Rules Are Fair, but the Game Isn't

ERIC Educational Resources Information Center

Jost, Muktha; Whitfield, Edward L.; Jost, Mark

2005-01-01

This article discusses the inequality in public education. The core issues of educational inequality are related to matters of race, social justice, democratic equality, and the diversity curriculum. Many of these issues are only marginally understood or accepted as legitimate by most teachers, teacher educators, and administrators (of any race)…

Inequalities in Educational Development: Papers Presented at an IIEP Seminar.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France). International Inst. for Educational Planning.

Based on the realization that the rapid worldwide growth of educational systems over the last two decades has not produced the expected eradication of social inequality, an international seminar was held for educational policy-makers, planners from developing countries, research workers in the area, and representatives of aid agencies from 33…

Embourgeoisment, Immiseration, Commodification--Marxism Revisited: A Critique of Education in Capitalist Systems

ERIC Educational Resources Information Center

Greaves, Nigel M.; Hill, Dave; Maisuria, Alpesh

2007-01-01

In this paper, we explore educational inequality through a theoretical and empirical analysis. We use classical Marxian scholarship and class-based analyses to theorise the relationship between education and the inequality in society that is an inevitable feature of capitalist society/ economy. The relationship between social class and the process…

International Struggles for Critical Democratic Education. Counterpoints: Studies in the Postmodern Theory of Education. Volume 427

ERIC Educational Resources Information Center

Knoester, Matthew, Ed.

2012-01-01

Drawing from rich data, "International Struggles for Critical Democratic Education" profiles teachers, students, and schools struggling to interrupt the reproduction of social inequalities from one generation to the next. International in its nature, the work collected here illustrates how forces of globalization create greater inequalities, and…

On the Assessment of Income Distribution: A Comment on the Secretariat Papers.

ERIC Educational Resources Information Center

Kravis, Irving B.

An assessment of three other conference papers summarizing knowledge of the inequalities in the distribution of personal income, education, and educational opportunities leads to fundamental questions about the appropriate framework and goals of public policy in the field of education, inequality, and life chances. Without a clear perception of…

Expanding Appreciation for "Others" among European-American Pre-Teacher Populations

ERIC Educational Resources Information Center

Ward, Carolyn Siemens

2003-01-01

Teachers play a key role in alleviating or exacerbating educational inequality across the nation. Oftentimes this educational inequality is based on ethnicity, class, and gender as well as additional cultural factors. It is essential that teacher education programs include courses that address multicultural issues with the goal of developing true…

Learning to Plunder: Global Education, Global Inequality and the Global City

ERIC Educational Resources Information Center

Tannock, Stuart

2010-01-01

Most research and policy discussions of education in the global city have focused on the ways in which globalization and the emergence of global or globalizing cities can create social, economic and educational inequality locally, within the global city itself. Global cities, however, are, by definition, powerful places, where the core…

Education and the Inequalities of Place

ERIC Educational Resources Information Center

Roscigno, Vincent J.; Tomaskovic-Devey, Donald; Crowley, Martha L.

2006-01-01

Students living in inner city and rural areas of the United States exhibit lower educational achievement and a higher likelihood of dropping out of high school than do their suburban counterparts. Educational research and policy has tended to neglect these inequalities or, at best, focus on one type but not the other. In this article, we integrate…

Building the Movement to End Educational Inequity

ERIC Educational Resources Information Center

Kopp, Wendy

2009-01-01

Teach for America (TFA) exists to address educational inequity--the stunning reality that in this nation, which aspires so admirably to be a land of equal opportunity, where one is born still largely determines one's educational outcomes. Despite plenty of evidence that children growing up in poverty can do well academically--when given the…

Building the Movement to End Educational Inequity

ERIC Educational Resources Information Center

Kopp, Wendy

2008-01-01

Teach for America exists to address educational inequity--the stunning reality that the American nation, which aspires so admirably to be a land of equal opportunity, where one is born still largely determines one's educational outcomes. Despite plenty of evidence that children growing up in poverty can do well academically--when given the…

Social Inequality and Access to Higher Education in Russia

ERIC Educational Resources Information Center

Konstantinovskiy, David L.

2012-01-01

This article analyses research on social inequality and access to higher education in Russia. It argues that the myth about equality of life chances, as with certain other myths, was an important part of the Soviet ideology. However, children from privileged groups traditionally received the education and professional training which were most…

Education in a World Wracked by Crisis

ERIC Educational Resources Information Center

Robertson, Susan

2015-01-01

The author argues that there have been major challenges to, and changes in, the role that education now plays in societies around the world. Pointing to growing social inequalities in countries like the USA and Europe, she explores the dynamics that have given rise to these education inequalities through a critical focus on five crises. She…

Language Education Policies and Inequality in Africa: Cross-National Empirical Evidence

ERIC Educational Resources Information Center

Coyne, Gary

2015-01-01

This article examines the relationship between inequality and education through the lens of colonial language education policies in African primary and secondary school curricula. The languages of former colonizers almost always occupy important places in society, yet they are not widely spoken as first languages, meaning that most people depend…

Social Exclusion and Inequality in Higher Education in China: A Capability Perspective

ERIC Educational Resources Information Center

Wang, Li

2011-01-01

Following calls for further research in education inequality beyond input and output measures, especially with a qualitative approach, and building on the implications of capability deprivation on equality (Unterhalter, 2003a,b), we extend the findings of Sen's (1979, 1990, 1992, 2000) capability approach to higher education (HE). This article…

Two Aspects of the Rural-Urban Divide and Educational Stratification in China: A Trajectory Analysis*

PubMed Central

Hao, Lingxin; Hu, Alfred; Lo, Jamie

2015-01-01

Contextualized in China’s social change of the past half-century, this paper develops the notion of dichotomous inequality to conceptualize the two aspects of China’s rural-urban divide in educational inequality—the household registration system (hukou) assigns people to a top-bottom hierarchy, and the rural-urban schooling system institutionalizes unequal resource distribution and diverse school mission. Based on this conceptualization, we formulate a Chinese version of the maximally maintained inequality (MMI) hypothesis. We capitalize on individual educational history data from the China General Social Survey (CGSS) 2008 and conduct a trajectory analysis using the generalized mixture modeling to estimate the differential effects of the two aspects of rural-urban divide on educational inequality in China. Findings indicate that (1) the sorting mechanism of the rural hukou places rural-hukou people in the very bottom of educational stratification, (2) the penalty of attending rural pre-tertiary school increases with educational stages, and (3) there is a cumulative disadvantage of rural hukou and rural school. Overall, our findings attest to the Chinese-version MMI and the behind principle of inequality reproduction. PMID:26166835

Socioeconomic inequalities in under-five mortality in rural Bangladesh: evidence from seven national surveys spreading over 20 years.

PubMed

Chowdhury, Asiful Haidar; Hanifi, Syed Manzoor Ahmed; Mia, Mohammad Nahid; Bhuiya, Abbas

2017-11-13

Socioeconomic inequality in health and mortality remains a disturbing reality across nations including Bangladesh. Inequality drew renewed attention globally. Bangladesh though made impressive progress in health, it makes an interesting case for learning. This paper examined the trends and changing pattern of socioeconomic inequalities in under-five mortality in rural Bangladesh. It also examined whether mother's education had any effect in reducing socioeconomic inequalities. Data from rural samples of seven Bangladesh Demographic Health Surveys, carried out so far, were used. Children born alive during 5 years preceding the surveys were included in the analysis. Univariate, bivariate and multivariate analyses were carried out. Under-five mortality rate steadily declined over the years from 128/1000 in 1994 to 48 in 2014. Females had 8% lower mortality rates than males. Children of mothers with no schooling had 1.88 times higher mortality than those whose mother had six or more years of schooling. Similarly, children from low asset category households had on an average 1.17 times higher mortality rate than those from high asset category households. Inequality by mother's education disappeared in the recent years, and inequality by household socioeconomic condition persisted all through. The pattern of inequality by sex, mother's education, and household socioeconomic status was not changed statistically significantly over the years, and mothers' education did not reduce socioeconomic inequalities. The reduction in mortality was consistent with changes in the proximate determinants of child survival in the country. Proximate determinants included maternal factors, environmental contamination, nutrient deficiency, personal illness control, and injury. Health and population programmes have been effective in increasing immunization coverage, use of ORS for managing diarrhoeal diseases, and increasing contraceptive use. Development activities on the other hand raised the literacy, especially among females, demand for modern health services, and reduction of poverty. However, socioeconomic inequality still exists in both under-five mortality and proximate determinants of child survival. The socioeconomic inequality in under-five mortality is showing resistance against further reduction. An assessment of the adequacy of the existing programmes taking the proximate determinants of child survival into consideration will be useful for further improvement.

Teaching social inequalities in health: barriers and opportunities.

PubMed

Muntaner, C

1999-09-01

This article examines some of the main threats and new opportunities encountered by teachers of social inequalities in health in contemporary academia. Focusing mostly on the recent US and European experiences, I suggest that lay world views legitimating social inequalities are often in conflict with explanations arising from social epidemiology and medical sociology. The dominance of medicine in public health, through its often implicit assumptions about the biological determinants of human behaviour, is also identified as a barrier to teaching social inequalities in health. Educational elitism, which restricts higher education to members of the upper middle class, is identified as another barrier to teaching social inequalities in health. On the other hand, teachers in this field can benefit from a recent growth of empirical studies during the last decade aimed at understanding the social determinants of health inequalities. Finally, I suggest that familiarity with current critical scholarship within public health, as well as the use of techniques developed by sociologists to teach social stratification, can be valuable resources for teaching social inequalities in health.

Marginalized identities, discrimination burden, and mental health: Empirical exploration of an interpersonal-level approach to modeling intersectionality

PubMed Central

Seng, Julia S; Lopez, William D; Sperlich, Mickey; Hamama, Lydia; Meldrum, Caroline D Reed

2012-01-01

Intersectionality is a term used to describe the intersecting effects of race, class, gender, and other marginalizing characteristics that contribute to social identity and affect health. Adverse health effects are thought to occur via social processes including discrimination and structural inequalities (i.e., reduced opportunities for education and income). Although intersectionality has been well-described conceptually, approaches to modeling it in quantitative studies of health outcomes are still emerging. Strategies to date have focused on modeling demographic characteristics as proxies for structural inequality. Our objective was to extend these methodological efforts by modeling intersectionality across three levels: structural, contextual, and interpersonal, consistent with a social-ecological framework. We conducted a secondary analysis of a database that included two components of a widely used survey instrument, the Everyday Discrimination Scale. We operationalized a meso- or interpersonal-level of intersectionality using two variables, the frequency score of discrimination experiences and the sum of characteristics listed as reasons for these (i.e., the person’s race, ethnicity, gender, sexual orientation, nationality, religion, disability or pregnancy status, or physical appearance). We controlled for two structural inequality factors (low education, poverty) and three contextual factors (high crime neighborhood, racial minority status, and trauma exposures). The outcome variables we modeled were posttraumatic stress disorder symptoms and a quality of life index score. We used data from 619 women who completed the Everyday Discrimination Scale for a perinatal study in the U.S. state of Michigan. Statistical results indicated that the two interpersonal-level variables (i.e., number of marginalized identities, frequency of discrimination) explained 15% of variance in posttraumatic stress symptoms and 13% of variance in quality of life scores, improving the predictive value of the models over those using structural inequality and contextual factors alone. This study’s results point to instrument development ideas to improve the statistical modeling of intersectionality in health and social science research. PMID:23089613

Marginalized identities, discrimination burden, and mental health: empirical exploration of an interpersonal-level approach to modeling intersectionality.

PubMed

Seng, Julia S; Lopez, William D; Sperlich, Mickey; Hamama, Lydia; Reed Meldrum, Caroline D

2012-12-01

Intersectionality is a term used to describe the intersecting effects of race, class, gender, and other marginalizing characteristics that contribute to social identity and affect health. Adverse health effects are thought to occur via social processes including discrimination and structural inequalities (i.e., reduced opportunities for education and income). Although intersectionality has been well-described conceptually, approaches to modeling it in quantitative studies of health outcomes are still emerging. Strategies to date have focused on modeling demographic characteristics as proxies for structural inequality. Our objective was to extend these methodological efforts by modeling intersectionality across three levels: structural, contextual, and interpersonal, consistent with a social-ecological framework. We conducted a secondary analysis of a database that included two components of a widely used survey instrument, the Everyday Discrimination Scale. We operationalized a meso- or interpersonal-level of intersectionality using two variables, the frequency score of discrimination experiences and the sum of characteristics listed as reasons for these (i.e., the person's race, ethnicity, gender, sexual orientation, nationality, religion, disability or pregnancy status, or physical appearance). We controlled for two structural inequality factors (low education, poverty) and three contextual factors (high crime neighborhood, racial minority status, and trauma exposures). The outcome variables we modeled were posttraumatic stress disorder symptoms and a quality of life index score. We used data from 619 women who completed the Everyday Discrimination Scale for a perinatal study in the U.S. state of Michigan. Statistical results indicated that the two interpersonal-level variables (i.e., number of marginalized identities, frequency of discrimination) explained 15% of variance in posttraumatic stress symptoms and 13% of variance in quality of life scores, improving the predictive value of the models over those using structural inequality and contextual factors alone. This study's results point to instrument development ideas to improve the statistical modeling of intersectionality in health and social science research. Copyright © 2012 Elsevier Ltd. All rights reserved.

Income inequality in today’s China

PubMed Central

Xie, Yu; Zhou, Xiang

2014-01-01

Using multiple data sources, we establish that China's income inequality since 2005 has reached very high levels, with the Gini coefficient in the range of 0.53–0.55. Analyzing comparable survey data collected in 2010 in China and the United States, we examine social determinants that help explain China’s high income inequality. Our results indicate that a substantial part of China’s high income inequality is due to regional disparities and the rural-urban gap. The contributions of these two structural forces are particularly strong in China, but they play a negligible role in generating the overall income inequality in the United States, where individual-level and family-level income determinants, such as family structure and race/ethnicity, play a much larger role. PMID:24778237

Income inequality in today's China.

PubMed

Xie, Yu; Zhou, Xiang

2014-05-13

Using multiple data sources, we establish that China's income inequality since 2005 has reached very high levels, with the Gini coefficient in the range of 0.53-0.55. Analyzing comparable survey data collected in 2010 in China and the United States, we examine social determinants that help explain China's high income inequality. Our results indicate that a substantial part of China's high income inequality is due to regional disparities and the rural-urban gap. The contributions of these two structural forces are particularly strong in China, but they play a negligible role in generating the overall income inequality in the United States, where individual-level and family-level income determinants, such as family structure and race/ethnicity, play a much larger role.

Educational inequality as a predictor of rising back pain prevalence in Austria-sex differences.

PubMed

Großschädl, Franziska; Stolz, Erwin; Mayerl, Hannes; Rásky, Éva; Freidl, Wolfgang; Stronegger, Willibald

2016-04-01

Back pain (BP) represents a widespread public health problem in Europe. The morbidity depends on several indicators, which must be investigated to discover risk groups. The examination of trends in socioeconomic developments should ensure a better understanding of the complex link between socioeconomic-status and BP. Therefore, the role of social inequalities for BP has been investigated among Austrian subpopulations over a 24-year period. Self-reported data from nationally representative health surveys (1983-2007) were analyzed and adjusted for self-report bias (N=121 486). Absolute changes (ACs) and aetiologic fractions (AF) were calculated to measure trends. To quantify the extent of social inequality, the relative index of inequality was computed based on educational levels. The prevalence of BP nearly doubled between 1983 and 2007. When investigating educational groups, subjects with low educational level were most prevalent. Obese persons generally showed higher rates of BP than non-obese subjects. Continuously rising trends across the different educational groups were more evident in men. The AC was highest in obese men with high education (+32.9%). Education-related inequalities for BP were more evident in men than women. Educational level is an important social indicator for BP. A gradient for low to high educational level in the trends of BP prevalence was clearly identified and stable only among men. We presume that the association 'education' and 'physical workload leading to BP' is more relevant for men than for women. The implementation of effective approaches to BP, in combination with target group-specific interventions focusing on educational status, is recommended. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Trends in Life Expectancy and Lifespan Variation by Educational Attainment: United States, 1990-2010.

PubMed

Sasson, Isaac

2016-04-01

The educational gradient in life expectancy is well documented in the United States and in other low-mortality countries. Highly educated Americans, on average, live longer than their low-educated counterparts, who have recently seen declines in adult life expectancy. However, limiting the discussion on lifespan inequality to mean differences alone overlooks other dimensions of inequality and particularly disparities in lifespan variation. The latter represents a unique form of inequality, with higher variation translating into greater uncertainty in the time of death from an individual standpoint, and higher group heterogeneity from a population perspective. Using data from the National Vital Statistics System from 1990 to 2010, this is the first study to document trends in both life expectancy and S25--the standard deviation of age at death above 25--by educational attainment. Among low-educated whites, adult life expectancy declined by 3.1 years for women and by 0.6 years for men. At the same time, S25 increased by about 1.5 years among high school-educated whites of both genders, becoming an increasingly important component of total lifespan inequality. By contrast, college-educated whites benefited from rising life expectancy and record low variation in age at death, consistent with the shifting mortality scenario. Among blacks, adult life expectancy increased, and S25 plateaued or declined in nearly all educational attainment groups, although blacks generally lagged behind whites of the same gender on both measures. Documenting trends in lifespan variation can therefore improve our understanding of lifespan inequality and point to diverging trajectories in adult mortality across socioeconomic strata.

Analysing horizontal equity in enrolment in Disease Management Programmes for coronary heart disease in Germany 2008-2010.

PubMed

Bozorgmehr, Kayvan; San Sebastian, Miguel; Brenner, Hermann; Razum, Oliver; Maier, Werner; Saum, Kai-Uwe; Holleczek, Bernd; Miksch, Antje; Szecsenyi, Joachim

2015-03-10

Disease Management Programmes (DMPs) have been introduced in Germany ten years ago with the aim to improve effectiveness and equity of care, but little is known about the degree to which enrolment in the programme meets the principles of equity in health care. We aimed to analyse horizontal equity in DMP enrolment among patients with coronary heart disease (CHD). Cross-sectional analysis of horizontal inequities in physician-reported enrolment in the DMP for CHD in a large population-based cohort-study in Germany (2008-2010). We calculated horizontal inequity indices (HII) and their 95% confidence intervals [95%CI] for predicted need-standardised DMP enrolment across two measures of socio-economic status (SES) (educational attainment, regional deprivation) stratified by sex. Need-standardised DMP enrolment was predicted in multi-level logistic regression models. Among N = 1,280 individuals aged 55-84 years and diagnosed with CHD, DMP enrolment rates were 22.2% (women) and 35.0% (men). Education-related inequities in need-standardised DMP enrolment favoured groups with lower education, but HII estimates were not significant. Deprivation-related inequities among women significantly favoured groups with higher SES (HII = 0.086 [0.007 ; 0.165]. No such deprivation-related inequities were seen among men (HII = 0.014 [-0.048 ; 0.077]). Deprivation-related inequities across the whole population favoured groups with higher SES (HII estimates not significant). Need-standardised DMP enrolment was fairly equitable across educational levels. Deprivation-related inequities in DMP enrolment favoured women living in less deprived areas relative to those living in areas with higher deprivation. Further research is needed to gain a better understanding of the mechanisms that contribute to deprivation-related horizontal inequities in DMP enrolment among women.

Social Inequalities on Selected Determinants of Active Aging and Health Status Indicators in a Large Brazilian City (2003-2010).

PubMed

Braga, Luciana de Souza; Lima-Costa, Maria Fernanda; César, Cibele Comini; Macinko, James

2016-02-01

To assess trends in social inequalities among 2,624 elderly living in Belo Horizonte, Brazil, in three domains of the World Health Organization's Active Aging model (physical environment, social determinants, use of health services) and health status indicators. Data came from two representative household surveys conducted in 2003 and 2010. Social inequality was measured by the slope and the relative index of inequality. Educational level was used to define socioeconomic status. Significant improvements were observed in the prevalence rates of 7 out of 12 indicators. However, the social inequalities persisted through 10 out of 12 selected active aging and health status indicators, except for fear of falling on the sidewalks/crossing the streets and fear of being robbed. Social inequalities persistence might be assigned to the continuity of unequal distribution of resources among groups with different educational levels. © The Author(s) 2015.

Rising U.S. income inequality, gender and individual self-rated health, 1972-2004.

PubMed

Zheng, Hui

2009-11-01

The effect of income inequality on health has been a contested topic among social scientists. Most previous research is based on cross-sectional comparisons rather than temporal comparisons. Using data from the General Social Survey and the U.S. Census Bureau, this study examines how rising income inequality affects individual self-rated health in the U.S. from 1972 to 2004. Data are analyzed using hierarchical generalized linear models. The findings suggest a significant association between income inequality and individual self-rated health. The dramatic increase in income inequality from 1972 to 2004 increases the odds of worse self-rated health by 9.4 percent. These findings hold for three measures of income inequality: the Gini coefficient, the Atkinson Index, and the Theil entropy index. Results also suggest that overall income inequality and gender-specific income inequality harm men's, but not women's, self-rated health. These findings also hold for the three measures of income inequality. These findings suggest that inattention to gender composition may explain apparent discrepancies across previous studies.

Diversification of Educational Provision and School-to-Work Transitions in Rural Mali: Analysing a Reconfiguration of Inequalities in Light of Justice Theories

ERIC Educational Resources Information Center

Weyer, Frederique

2011-01-01

Based on an approach focusing on actors and in particular on educational trajectories, this paper analyses the effects of diversification of educational provision on inequalities in rural Mali. It shows that there are considerable gaps in the skills acquired by students, including within formal education. These gaps are perceived as illegitimate…

Changes in Socio-Economic Inequality in Neonatal Mortality in Iran Between 1995-2000 and 2005-2010: An Oaxaca Decomposition Analysis.

PubMed

Amini Rarani, Mostafa; Rashidian, Arash; Khosravi, Ardeshir; Arab, Mohammad; Abbasian, Ezatollah; Khedmati Morasae, Esmaeil

2016-09-24

Exploring changes in health inequality and its determinants over time is of policy interest. Accordingly, this study aimed to decompose inequality in neonatal mortality into its contributing factors and then explore changes from 1995-2000 to 2005-2010 in Iran. Required data were drawn from two Iran's demographic and health survey (DHS) conducted in 2000 and 2010. Normalized concentration index (CI) was used to measure the magnitude of inequality in neonatal mortality. The contribution of various determinants to inequality was estimated by decomposing concentration indices in 1995-2000 and 2005-2010. Finally, changes in inequality were investigated using Oaxaca-type decomposition technique. Pro-rich inequality in neonatal mortality was declined by 16%, ie, the normalized CI dropped from -0.1490 in 1995-2000 to -0.1254 in 2005-2010. The largest contribution to inequality was attributable to mother's education (32%) and household's economic status (49%) in 1995-2000 and 2005-2010, respectively. Changes in mother's educational level (121%), use of skilled birth attendants (79%), mother's age at the delivery time (25-34 years old) (54%) and using modern contraceptive (29%) were mainly accountable for the decrease in inequality in neonatal mortality. Policy actions on improving households' economic status and maternal education, especially in rural areas, may have led to the reduction in neonatal mortality inequality in Iran. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Adult learning and social inequalities: Processes of equalisation or cumulative disadvantage?

NASA Astrophysics Data System (ADS)

Kilpi-Jakonen, Elina; Vono de Vilhena, Daniela; Blossfeld, Hans-Peter

2015-08-01

Adult learning is an increasingly important form of education in globalised and aging societies. While current policy recommendations tend to focus on increasing participation rates, the authors of this article argue that higher participation rates do not necessarily lead to lower social/educational inequalities in participation. The aim of this paper is to examine the relationship between social inequalities and adult learning by exploring cross-national patterns of participation in different adult learning activities and the consequences of participation on individual labour market trajectories. The empirical basis of the paper is an analysis of 13 country studies (as well as two cross-national analyses) brought together by the international comparative research project "Education as a lifelong process - comparing educational trajectories in modern societies" ( eduLIFE). Despite wide variations in participation rates across countries, mechanisms of social/educational inequality in engagement in job-related adult learning tend to be relatively similar across countries, in particular with regard to non-formal learning. Effects tend most frequently to be a presence of cumulative advantage, though in some countries a certain degree of equalisation is noticeable with regard to formal adult education. The authors conclude that it is relatively clear that currently almost no country is truly able to reduce social inequalities through adult learning. Their recommendation is that public policy makers should place greater emphasis on making adult learning more accessible (in terms of entry requirements, affordability as well as motivation) to underrepresented groups, in particular those who are educationally disadvantaged.

Socioeconomic inequalities in all-cause mortality in the Czech Republic, Russia, Poland and Lithuania in the 2000s: findings from the HAPIEE Study.

PubMed

Vandenheede, Hadewijch; Vikhireva, Olga; Pikhart, Hynek; Kubinova, Ruzena; Malyutina, Sofia; Pajak, Andrzej; Tamosiunas, Abdonas; Peasey, Anne; Simonova, Galina; Topor-Madry, Roman; Marmot, Michael; Bobak, Martin

2014-04-01

Relatively large socioeconomic inequalities in health and mortality have been observed in Central and Eastern Europe (CEE) and the former Soviet Union (FSU). Yet comparative data are sparse and virtually all studies include only education. The aim of this study is to quantify and compare socioeconomic inequalities in all-cause mortality during the 2000s in urban population samples from four CEE/FSU countries, by three different measures of socioeconomic position (SEP) (education, difficulty buying food and household amenities), reflecting different aspects of SEP. Data from the prospective population-based HAPIEE (Health, Alcohol, and Psychosocial factors in Eastern Europe) study were used. The baseline survey (2002-2005) included 16 812 men and 19 180 women aged 45-69 years in Novosibirsk (Russia), Krakow (Poland), Kaunas (Lithuania) and seven Czech towns. Deaths in the cohorts were identified through mortality registers. Data were analysed by direct standardisation and Cox regression, quantifying absolute and relative SEP differences. Mortality inequalities by the three SEP indicators were observed in all samples. The magnitude of inequalities varied according to gender, country and SEP measure. As expected, given the high mortality rates in Russian men, largest absolute inequalities were found among Russian men (educational slope index of inequality was 19.4 per 1000 person-years). Largest relative inequalities were observed in Czech men and Lithuanian subjects. Disadvantage by all three SEP measures remained strongly associated with increased mortality after adjusting for the other SEP indicators. The results emphasise the importance of all SEP measures for understanding mortality inequalities in CEE/FSU.

Educational inequalities in falls mortality among older adults: population-based multiple cause of death data from Sweden.

PubMed

Ahmad Kiadaliri, Aliasghar; Turkiewicz, Aleksandra; Englund, Martin

2018-01-01

Falls are the leading cause of fatal injuries among elderly adults. While socioeconomic status including education is a well-documented predictor of many individual health outcomes including mortality, little is known about socioeconomic inequalities in falls mortality among adults. This study aimed to assess educational inequalities in falls mortality among older adults in Sweden using multiple cause of death data. All residents aged 50‒75 years in the Skåne region, Sweden, during 1998‒2013 (n=566 478) were followed until death, relocation outside Skåne or end of 2014. We identified any mention of falls on death certificates (n=1047). We defined three levels of education. We used an additive hazards model and Cox regression with age as time scale adjusted for marital status and country of birth to calculate slope and relative indices of inequality (SII/RII). We also computed the population attributable fraction of lower educational attainment. Analyses were performed separately for men and women. Both SII and RII revealed statistically significant educational inequalities in falls mortality among men in favour of high educated (SII (95% CI): 15.5 (9.8 to 21.3) per 100 000 person-years; RII: 2.19 (1.60 to 3.00)) but not among women. Among men, 34% (95% CI 19 to 46) of falls deaths were attributable to lower education. There was an inverse association between education and deaths from falls among men but not women. The results suggest that individual's education should be considered in falls reduction interventions. © 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.

Classroom Conversations in the Study of Race and the Disruption of Social and Educational Inequalities: A Review of Research

ERIC Educational Resources Information Center

Brown, Ayanna F.; Bloome, David; Morris, Jerome E.; Power-Carter, Stephanie; Willis, Arlette I.

2017-01-01

This review of research examines classroom conversations about race with a theoretical framing oriented to understanding how such conversations may disrupt social and educational inequalities. The review covers research on how classroom conversations on race contribute to students' and educators' understandings of a racialized society, their…

Regional Inequality of Higher Education in China and the Role of Unequal Economic Development

ERIC Educational Resources Information Center

Bickenbach, Frank; Liu, Wan-Hsin

2013-01-01

Over the past decade the scale of higher education in China has expanded substantially. Regional development policies have attempted to make use of scale expansion as a tool to reduce inequality of higher education among regions with different development levels by providing poor regions with preferential treatment and support. This paper analyzes…

The Role of Borders in Environmental Education: Positioning, Power and Marginality

ERIC Educational Resources Information Center

Tzou, Carrie T.; Bell, Philip

2012-01-01

In this study, we argue that in order to understand the underlying causes of inequities in education, we need to look outside specific educational settings to the larger social, historical and political structures behind those inequities. Therefore, in this work we take a social justice perspective to look at the relationship between environmental…

The Role of Social Capital in the Explanation of Educational Success and Educational Inequalities

ERIC Educational Resources Information Center

Roth, Tobias

2013-01-01

This article examines the role that social capital plays in school success and in the explanation of social and ethnic inequalities in the German educational system. Based on Coleman's well-known concept of social capital, different aspects of social capital are distinguished, including social network composition, parent-school interaction and…

Compensatory Policies Attending Equality and Inequality in Mexico Educational Practice among Vulnerable Groups in Higher Education

ERIC Educational Resources Information Center

Flores, René Pedroza; Monroy, Guadalupe Villalobos; Fabela, Ana María Reyes

2015-01-01

This paper presents an estimate of the prevalence of social inequality in accessing higher education among vulnerable groups in Mexico. Estimates were determined from statistical data provided by governmental agencies on the level of poverty among the Mexican population. In Mexico, the conditions of poverty and vulnerability while trying to access…

"Locking the Door before We Got the Keys": Racial Realities of the Charter School Authorization Process in Post-Katrina New Orleans

ERIC Educational Resources Information Center

Henry, Kevin Lawrence, Jr.; Dixson, Adrienne D.

2016-01-01

Charter schools have become the hegemonic "solution" for urban educational reform initiatives aimed at curtailing longstanding race-based educational inequities. The "common sense" of neoliberal charter schools as the cure to persistent inequality is best illustrated in the post-Katrina New Orleans educational reforms. This…

The Spatialization of Racial Inequity and Educational Opportunity:Rethinking the Rural/Urban Divide

ERIC Educational Resources Information Center

Tieken, Mara Casey

2017-01-01

This analysis recounts and examines the history of American public education, focusing on the experiences of poor urban and rural students of color. Using the lens of critical race theory, it suggests that educational inequity is not just raced and classed but also spatialized--that is, embedded in and maintained through geography. The mechanisms…

Equalities and Inequalities in the English Education System

ERIC Educational Resources Information Center

Scott, David; Scott, Ben

2018-01-01

This book is about social categories such as gender, race, dis-ability, intelligence, sexuality and class, as they are used in education. Knowledge of and about them and their effects is central to how we can understand society, equalities and inequalities within it, and educational relations. The evidence to support the claims being made in this…

Higher Education as Modulator of Gender Inequalities: Evidence of the Spanish Case

ERIC Educational Resources Information Center

Pastor, José Manuel; Peraita, Carlos; Soler, Ángel

2016-01-01

Raising educational levels may help to reduce inequalities between men and women in certain social and economic aspects. Using statistics for Spain, we analyse labour market behaviours such as the rates of activity and unemployment by sex according to the educational level. The results reveal that the differences between men and women decrease as…

Gender Inequality and Disabled Inclusivity in Accounting Higher Education and the Accounting Profession during Financial Crises

ERIC Educational Resources Information Center

Lodh, Suman; Nandy, Monomita

2017-01-01

In this article, the authors find that, during financial crises, the wage gap between female and male accounting professionals declines and gender inequality in higher education is affected. In addition, less support and lower wages for disabled accounting professionals demotivate disabled students in accounting higher education. Because of budget…

Standardization of Lower Secondary Civic Education and Inequality of the Civic and Political Engagement of Students

ERIC Educational Resources Information Center

Witschge, Jacqueline; van de Werfhorst, Herman G.

2016-01-01

In this paper, the relation between the standardization of civic education and the inequality of civic engagement is examined. Using data from the International Civic and Citizenship Education Study 2009 among early adolescents and Eurydice country-level data, three-level analysis and variance function regression are applied to examine whether…

Not by Productivity Alone: How Visibility and Specialization Contribute to Academic Earnings

ERIC Educational Resources Information Center

Leahey, Erin

2007-01-01

The popular adage "publish or perish" has long defined individual career strategies as well as scholarly investigations of earnings inequality in academe, as researchers have relied heavily on research productivity to explain earnings inequality among faculty members. Academia, however, has changed dramatically in the last few decades: it has…

Explaining Relative Incomes of Low-Income Families in U.S. Cities.

ERIC Educational Resources Information Center

Blackley, Paul R.

1988-01-01

Uses an interurban analysis model to assess the position of lower income families. Identifies factors determining the relative incomes of the poor through use of a supply and demand model of aggregate income inequality. Found high school graduation a significant factor in income inequality. Implications for policy are discussed. (KO)

How Culture Affects Female Inequality across Countries: An Empirical Study

ERIC Educational Resources Information Center

Cheung, Hoi Yan; Chan, Alex W. H.

2007-01-01

Many studies have commented that culture has an influence on gender inequality. However, few studies have provided data that could be used to investigate how culture actually influences female inequality. One of the aims of this study is to investigate whether Hofstede's cultural dimensions have an impact on female inequality in education in terms…

Do free caesarean section policies increase inequalities in Benin and Mali?

PubMed

Ravit, Marion; Audibert, Martine; Ridde, Valéry; De Loenzien, Myriam; Schantz, Clémence; Dumont, Alexandre

2018-06-05

Benin and Mali introduced user fee exemption policies focused on caesarean sections (C-sections) in 2005 and 2009, respectively. These policies had a positive impact on access to C-sections and facility based deliveries among all women, but the impact on socioeconomic inequality is still highly uncertain. The objective of this study was to observe whether there was an increase or a decrease in urban/rural and socioeconomic inequalities in access to C-sections and facility based deliveries after the free C-section policy was introduced. We used data from three consecutive Demographic and Health Surveys (DHS): 2001, 2006 and 2011-2012 in Benin and 2001, 2006 and 2012-13 in Mali. We evaluated trends in inequality in terms of two outcomes: C-sections and facility based deliveries. Adjusted odds ratios were used to estimate whether the distributions of C-sections and facility based deliveries favoured the least advantaged categories (rural, non-educated and poorest women) or the most advantaged categories (urban, educated and richest women). Concentration curves were used to observe the degree of wealth-related inequality in access to C-sections and facility based deliveries. We analysed 47,302 childbirths (23,266 in Benin and 24,036 in Mali). In Benin, we found no significant difference in access to C-sections between urban and rural women or between educated and non-educated women. However, the richest women had greater access to C-sections than the poorest women. There was no significant change in these inequalities in terms of access to C-sections and facility based deliveries after introduction of the free C-section policy. In Mali, we found a reduction in education-related inequalities in access to C-sections after implementation of the policy (p-value = 0.043). Inequalities between urban and rural areas had already decreased prior to implementation of the policy, but wealth-related inequalities were still present. Urban/rural and socioeconomic inequalities in C-section access did not change substantially after the countries implemented free C-section policies. User fee exemption is not enough. We recommend switching to mechanisms that combine both a universal approach and targeted action for vulnerable populations to address this issue and ensure equal health care access for all individuals.

Health trends in the wake of the financial crisis-increasing inequalities?

PubMed

Nelson, Kenneth; Tøge, Anne Grete

2017-08-01

The financial crisis that hit Europe in 2007-2008 and the corresponding austerity policies have generated concern about increasing health inequalities, although impacts have been less salient than initially expected. One explanation could be that health inequalities emerged first a few years into the crisis. This study investigates health trends in the wake of the financial crisis and analyses health inequalities across a number of relevant population subgroups, including those defined by employment status, age, family type, gender, and educational attainment. This study uses individual-level panel data (EU-SILC, 2010-2013) to investigate trends in self-rated health. By applying individual fixed effects regression models, the study estimates the average yearly change in self-rated health for persons aged 15-64 years in 28 European countries. Health inequalities are investigated using stratified analyses. Unemployed respondents, particularly those who were unemployed in all years of observation, had a steeper decline in self-rated health than the employed. Respondents of prime working age (25-54 years) had a steeper decline than their younger (15-24) and older (55-64) counterparts, while single parents had a more favorable trend in self-rated health than dual parents. We did not observe any increasing health inequalities based on gender or educational attainment. Health inequalities increased in the wake of the financial crisis, especially those associated with employment status, age, and family type. We did not observe increasing health inequalities in terms of levels of educational attainment and gender.

Socioeconomic inequalities in cause specific mortality among older people in France.

PubMed

Menvielle, Gwenn; Leclerc, Annette; Chastang, Jean-François; Luce, Danièle

2010-05-19

European comparative studies documented a clear North-South divide in socioeconomic inequalities with cancer being the most important contributor to inequalities in total mortality among middle aged men in Latin Europe (France, Spain, Portugal, Italy). The aim of this paper is to investigate educational inequalities in mortality by gender, age and causes of death in France, with a special emphasis on people aged 75 years and more. We used data from a longitudinal population sample that includes 1% of the French population. Risk of death (total and cause specific) in the period 1990-1999 according to education was analysed using Cox regression models by age group (45-59, 60-74, and 75+). Inequalities were quantified using both relative (ratio) and absolute (difference) measures. Relative inequalities decreased with age but were still observed in the oldest age group. Absolute inequalities increased with age. This increase was particularly pronounced for cardiovascular diseases. The contribution of different causes of death to absolute inequalities in total mortality differed between age groups. In particular, the contribution of cancer deaths decreased substantially between the age groups 60-74 years and 75 years and more, both in men and in women. This study suggests that the large contribution of cancer deaths to the excess mortality among low educated people that was observed among middle aged men in Latin Europe is not observed among French people aged 75 years and more. This should be confirmed among other Latin Europe countries.

Socio-economic inequalities in overweight among adults in Turkey: a regional evaluation.

PubMed

Ergin, Isil; Hassoy, Hur; Kunst, Anton

2012-01-01

Patterns of socio-economic inequalities in obesity and overweight have not been documented for Turkey. The present study aimed to describe educational and wealth-related inequalities for overweight in Turkey, taking a regional perspective. Cross-sectional self-reported data of the World Health Survey 2002 for Turkey were used. BMI ≥ 25·00 kg/m2 was considered as overweight. Respondents were classified according to education years and a wealth score derived from the availability of household assets. Logistic regression analysis was applied to assess the relationship between overweight and socio-economic factors. Analyses were stratified by sex and region (West, Mediterranean, Middle, Black Sea and East). Turkey. Among the respondents 20 years and older, 3790 women and 4057 men had data on self-reported height and weight. Age-adjusted overweight prevalence was 48·4 % for women and 46·1 % for men. For men, education was not systematically related to overweight while overweight was significantly increased among the highest wealth groups. For women, the prevalence of overweight was highest for low-educated and middle-wealth groups. The size of the inequalities in overweight showed only small regional variations. In the East, however, overweight prevalence was more related to higher socio-economic position than in the other regions. Socio-economic inequalities for overweight in Turkey are at a similar level as in most European countries, and especially comparable to Southern Europe. The smaller inequalities in the East correspond to the low level of socio-economic development in this part of the country. Prevention of overweight should focus on lower educational groups throughout the entire country and especially on low-educated women.

[Educational inequalities in mortality and survival of women and men in the Americas, 1990-2010].

PubMed

Haeberer, Mariana; Noguer, Isabel; Mújica, Oscar J

2015-08-01

Analyze magnitude and trends in educational inequality in mortality and survival of women and men in countries of the Americas. Gap and gradient metrics were used to calculate inequality between countries in adult mortality, average age of death, life expectancy, and healthy life expectancy, according to educational level in men and women for 1990 and 2010. Between 1990 and 2010, the average number of years of education increased from 8 to 10 with no difference between sexes. Adult mortality (15-59 years) did not change: 1.9 per 1 000 women and 3.7 per 1 000 men. The slope index of inequality (SII) increased from -1.0 to -2.0 per 1 000 women and from -1.2 to -4.4 per 1 000 men. Life expectancy increased from 75.6 to 78.7 years in women and from 68.9 to 72.4 in men; absolute inequality decreased from 7.8 to 7.2 years in women and increased from 7.2 to 9.2 years in men. Healthy life expectancy increased from 63.7 to 65.9 years in women and from 59.5 to 62.5 years in men; the SII declined from 6.9 to 5.8 years in women and increased from 6.9 to 7.8 years in men. In the countries of the Americas, men are at greater risk of dying, die earlier, and live fewer disease- and disability-free years than women; educational level is a determinant of mortality and survival in both sexes, and educational inequalities are more pronounced and increasing among men, and are disproportionately concentrated in the most socially disadvantaged populations.

Psychosocial and behavioural factors in the explanation of socioeconomic inequalities in adolescent health: a multilevel analysis in 28 European and North American countries.

PubMed

Moor, Irene; Rathmann, Katharina; Stronks, Karien; Levin, Kate; Spallek, Jacob; Richter, Matthias

2014-10-01

The relative contribution of different pathways leading to health inequalities in adolescence was rarely investigated, especially in a cross-national perspective. The aim of the study is to analyse the contribution of psychosocial and behavioural factors in the explanation of inequalities in adolescent self-rated health (SRH) by family wealth in 28 countries. This study was based on the international WHO 'Health Behaviour in School-aged Children' (HBSC) study carried out in 2005/2006. The total sample included 117 460 adolescents aged 11-15 in 28 European and North American countries. Socioeconomic position was measured using the Family Affluence Scale (FAS). Multilevel logistic regression models were conducted to analyse the direct (independent) and indirect contribution of psychosocial and behavioural factors on SRH. Across all countries, adolescents from low affluent families had a higher risk of reporting fair/poor SRH (OR1.76, CI 1.69 to 1.84). Separate adjustments for psychosocial and behavioural factors reduced the OR of students with low family affluence by 39% (psychosocial) and 22% (behavioural). Together, both approaches explained about 50-60% of inequalities by family affluence in adolescent SRH. Separate analyses showed that relationship to father and academic achievement (psychosocial factors) as well as physical activity and consumption of fruits/vegetables (behavioural factors) were the most important factors in explaining inequalities in SRH. More than half of the inequalities by family affluence in adolescent SRH were explained by an unequal distribution of psychosocial and behavioural factors. Combining both approaches showed that the contribution of psychosocial factors was higher due to their direct (independent) and indirect impact through behavioural factors. 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.

An Investigation into the Relationship between the 1997 Universal Primary Education (UPE) Policy and Regional Poverty and Educational Inequalities in Uganda (1997-2007)

ERIC Educational Resources Information Center

Ekaju, John

2012-01-01

Past research has addressed the disparities in educational achievement for primary year seven school leavers in Uganda but it did not take into account the multidimensional perspectives: those on poverty (as reported by the poor) and on educational inequalities between and within regions, particularly with regard to the impacts of the 1997…

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

How equitable is the uptake of conditional cash transfers for maternity care in India? Evidence from the Janani Suraksha Yojana scheme in Odisha and Jharkhand.

PubMed

Thongkong, Nattawut; van de Poel, Ellen; Roy, Swati Sarbani; Rath, Shibanand; Houweling, Tanja A J

2017-03-10

In 2005, the Indian Government introduced the Janani Suraksha Yojana (JSY) scheme - a conditional cash transfer program that incentivizes women to deliver in a health facility - in order to reduce maternal and neonatal mortality. Our study aimed to measure and explain socioeconomic inequality in the receipt of JSY benefits. We used prospectively collected data on 3,682 births (in 2009-2010) from a demographic surveillance system in five districts in Jharkhand and Odisha state, India. Linear probability models were used to identify the determinants of receipt of JSY benefits. Poor-rich inequality in the receipt of JSY benefits was measured by a corrected concentration index (CI), and the most important drivers of this inequality were identified using decomposition techniques. While the majority of women had heard of the scheme (94% in Odisha, 85% in Jharkhand), receipt of JSY benefits was comparatively low (62% in Odisha, 20% in Jharkhand). Receipt of the benefits was highly variable by district, especially in Jharkhand, where 5% of women in Godda district received the benefits, compared with 40% of women in Ranchi district. There were substantial pro-rich inequalities in JSY receipt (CI 0.10, standard deviation (SD) 0.03 in Odisha; CI 0.18, SD 0.02 in Jharkhand) and in the institutional delivery rate (CI 0.16, SD 0.03 in Odisha; CI 0.30, SD 0.02 in Jharkhand). Delivery in a public facility was an important determinant of receipt of JSY benefits and explained a substantial part of the observed poor-rich inequalities in receipt of the benefits. Yet, even among public facility births in Jharkhand, pro-rich inequality in JSY receipt was substantial (CI 0.14, SD 0.05). This was largely explained by district-level differences in wealth and JSY receipt. Conversely, in Odisha, poorer women delivering in a government institution were at least as likely to receive JSY benefits as richer women (CI -0.05, SD 0.03). JSY benefits were not equally distributed, favouring wealthier groups. These inequalities in turn reflected pro-rich inequalities in the institutional delivery. The JSY scheme is currently not sufficient to close the poor-rich gap in institutional delivery rate. Important barriers to institutional delivery remain to be addressed and more support is needed for low performing districts and states.

Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors.

PubMed

Kong, Kyoung Ae; Khang, Young-Ho; Cho, Hong-Jun; Jang, Sung-Mi; Jung-Choi, Kyunghee

2017-04-20

The aim of this study was to examine the pattern of social inequality in self-rated health among the employed using the Wright's social class location indicator, and to assess the roles of material, behavioral, psychosocial, and workplace environmental factors as mediating factors in explaining the social class inequality in self-rated health in South Korea. This study used data from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Study subjects included the employed population of 4392 men and 3309 women aged 19-64 years. Subjects were classified into twelve social class positions based on the Wright's social class map. The health outcome was self-rated health. Material, psychosocial, behavioral, and workplace environmental factors were considered as potential mediators in explaining social class health inequality. We calculated prevalence ratios of poor self-rated health according to social class, adjusted for age and mediating factors using Poisson regression models. Nonskilled workers and petty bourgeoisie reported worse self-rated health than other social classes among men. The age-adjusted prevalence of petty bourgeoisie and nonskilled workers were about four-fold greater than that of managers. Expert supervisors in the contradictory class location had a greater prevalence of poor self-rated health than experts in men. In women, the prevalence of poor self-rated health was greater in most social classes than their male counterparts, while the differences among social classes within women were not statistically significant. Workplace environmental factors explained the social class inequality by from 24 to 31% in nonskilled and skilled workers and nonskilled supervisors, respectively, and material factors showed an explanatory ability of about 8% for both nonskilled workers and petty bourgeoisie in men. We showed the inequality in self-rated health according to the Wright's social class in an industrialized Asian country. Policy efforts to improve workplace environments in nonskilled and skilled workers and nonskilled supervisors would have a moderate effect on reducing the magnitude of social class inequality in self-rated health. Furthermore, the means to improve power relations in the workplace should be devised to further reduce the social class inequalities in health.

'Only Fathers Smoking' Contributes the Most to Socioeconomic Inequalities: Changes in Socioeconomic Inequalities in Infants' Exposure to Second Hand Smoke over Time in Japan.

PubMed

Saito, Junko; Tabuchi, Takahiro; Shibanuma, Akira; Yasuoka, Junko; Nakamura, Masakazu; Jimba, Masamine

2015-01-01

Exposure to second hand smoke (SHS) is one of the major causes of premature death and disease among children. While socioeconomic inequalities exist for adult smoking, such evidence is limited for SHS exposure in children. Thus, this study examined changes over time in socioeconomic inequalities in infants' SHS exposure in Japan. This is a repeated cross-sectional study of 41,833 infants born in 2001 and 32,120 infants born in 2010 in Japan from nationally representative surveys using questionnaires. The prevalence of infants' SHS exposure was determined and related to household income and parental education level. The magnitudes of income and educational inequalities in infants' SHS exposure were estimated in 2001 and 2010 using both absolute and relative inequality indices. The prevalence of SHS exposure in infants declined from 2001 to 2010. The relative index of inequality increased from 0.85 (95% confidence interval [CI], 0.80 to 0.89) to 1.47 (95% CI, 1.37 to 1.56) based on income and from 1.22 (95% CI, 1.17 to 1.26) to 2.09 (95% CI, 2.00 to 2.17) based on education. In contrast, the slope index of inequality decreased from 30.9 (95% CI, 29.3 to 32.6) to 20.1 (95% CI, 18.7 to 21.5) based on income and from 44.6 (95% CI, 43.1 to 46.2) to 28.7 (95% CI, 27.3 to 30.0) based on education. Having only a father who smoked indoors was a major contributor to absolute income inequality in infants' SHS exposure in 2010, which increased in importance from 45.1% in 2001 to 67.0% in 2010. The socioeconomic inequalities in infants' second hand smoke exposure increased in relative terms but decreased in absolute terms from 2001 to 2010. Further efforts are needed to encourage parents to quit smoking and protect infants from second hand smoke exposure, especially in low socioeconomic households that include non-smoking mothers.

Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey

PubMed Central

2012-01-01

Background Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. Methods This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002–2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. Results Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. Conclusions Disaggregated analysis of the prevalence of non-communicable disease risk factors demonstrated different patterns and varying degrees of socioeconomic inequalities across low- and middle-income settings. Interventions should aim to reach and achieve sustained benefits for high-risk populations. PMID:23102008

‘Only Fathers Smoking’ Contributes the Most to Socioeconomic Inequalities: Changes in Socioeconomic Inequalities in Infants’ Exposure to Second Hand Smoke over Time in Japan

PubMed Central

Saito, Junko; Tabuchi, Takahiro; Shibanuma, Akira; Yasuoka, Junko; Nakamura, Masakazu; Jimba, Masamine

2015-01-01

Background Exposure to second hand smoke (SHS) is one of the major causes of premature death and disease among children. While socioeconomic inequalities exist for adult smoking, such evidence is limited for SHS exposure in children. Thus, this study examined changes over time in socioeconomic inequalities in infants’ SHS exposure in Japan. Methods This is a repeated cross-sectional study of 41,833 infants born in 2001 and 32,120 infants born in 2010 in Japan from nationally representative surveys using questionnaires. The prevalence of infants’ SHS exposure was determined and related to household income and parental education level. The magnitudes of income and educational inequalities in infants’ SHS exposure were estimated in 2001 and 2010 using both absolute and relative inequality indices. Results The prevalence of SHS exposure in infants declined from 2001 to 2010. The relative index of inequality increased from 0.85 (95% confidence interval [CI], 0.80 to 0.89) to 1.47 (95% CI, 1.37 to 1.56) based on income and from 1.22 (95% CI, 1.17 to 1.26) to 2.09 (95% CI, 2.00 to 2.17) based on education. In contrast, the slope index of inequality decreased from 30.9 (95% CI, 29.3 to 32.6) to 20.1 (95% CI, 18.7 to 21.5) based on income and from 44.6 (95% CI, 43.1 to 46.2) to 28.7 (95% CI, 27.3 to 30.0) based on education. Having only a father who smoked indoors was a major contributor to absolute income inequality in infants’ SHS exposure in 2010, which increased in importance from 45.1% in 2001 to 67.0% in 2010. Conclusions The socioeconomic inequalities in infants’ second hand smoke exposure increased in relative terms but decreased in absolute terms from 2001 to 2010. Further efforts are needed to encourage parents to quit smoking and protect infants from second hand smoke exposure, especially in low socioeconomic households that include non-smoking mothers. PMID:26431400

Income inequality and fear of crime across the European region

PubMed Central

Vauclair, Christin-Melanie; Bratanova, Boyka

2016-01-01

This paper aims to take a holistic approach to studying fear of crime by testing predictors at multiple levels of analyses. Data from the European Social Survey (N = 56,752 from 29 countries) were used to test and extend the Income Inequality and Sense of Vulnerability Hypotheses. The findings confirm that (1) individuals in societies with greater income inequalities are more fearful of crime, and (2) older or disabled people as well as women report greater fear of crime. Contrary to the hypotheses, ethnic majority and not ethnic minority members report greater fear of crime, if they reside in high income inequality countries. It is further demonstrated that fear of crime explains the inverse association between income inequality and subjective well-being in this particular subsample. PMID:28579924

Socioeconomic inequality and its determinants regarding infant mortality in iran.

PubMed

Damghanian, Maryam; Shariati, Mohammad; Mirzaiinajmabadi, Khadigeh; Yunesian, Masud; Emamian, Mohammad Hassan

2014-06-01

Infant mortality rate is a useful indicator of health conditions in the society, the racial and socioeconomic inequality of which is from the most important measures of social inequality. The aim of this study was to determine the socioeconomic inequality and its determinants regarding infant mortality in an Iranian population. This cross-sectional study was performed on 3794 children born during 2010-2011 in Shahroud, Iran. Based on children's addresses and phone numbers, 3412 were available and finally 3297 participated in the study. A data collection form was filled out through interviewing the mothers as well as using health records. Using principal component analysis, the study population was divided to high and low socioeconomic groups based on the case's home asset, education and job of the household's head, marital status, and composition of the household members. Inequality between the groups with regard to infant mortality was investigated by Blinder-Oaxaca decomposition method. The mortality rate was 15.1 per 1000 live births in the high socioeconomic group and 42.3 per 1000 in the low socioeconomic group. Mother's education, consanguinity of parents, and infant's nutrition type and birth weight constituted 44% of the gap contributing factors. Child's gender, high-risk pregnancy, and living area had no impact on the gap. There was considerable socioeconomic inequality regarding infant mortality in Shahroud. Mother's education was the most contributing factor in this inequality.

Educational Equity in Poor Urban Contexts--Exploring Issues of Place/Space and Young People's Identity and Agency

ERIC Educational Resources Information Center

Raffo, Carlo

2011-01-01

An enduring concern for educational policy in many affluent countries is the endemic nature of educational inequalities that are predominately located in poor urban contexts. Given the inabilities of school reform "per se" to deal with these inequalities, the paper focuses on issues of scarcity and spatial processes that are implicated…

The Operation of Grade Retention and Educational Inequality: Who Gets Retained in Macao and Why?

ERIC Educational Resources Information Center

Wong, Yi-Lee; Zhou, Yisu

2017-01-01

While the existence of a class, gender, or ethnic gap in educational attainment is well documented for many societies, how the practice of grade retention contributes to these patterns of educational inequality has been inadequately addressed. Given that grade retention is commonly practised in Macao, Macao is used as a case for illustration.…

The Postgraduate Premium: Revisiting Trends in Social Mobility and Educational Inequalities in Britain and America

ERIC Educational Resources Information Center

Lindley, Joanne; Machin, Stephen

2013-01-01

This report revisits the debate about why social mobility levels are relatively low in Great Britain and the United States of America compared to other countries. It focuses on three main areas within this debate: (1) the changing role of educational inequalities; (2) the expectation of ever higher levels of education as revealed in increasing…

Crosses to Bear and Promises to Keep: The Jubilee Anniversary of Brown v. Board of Education

ERIC Educational Resources Information Center

Anderson, James D.

2004-01-01

This article examines a decade or more of scholarly and popular writings that blame the persistence of racial inequality in educational performance primarily, if not exclusively, on the cultural inheritance of African Americans. This article focuses in part on the ways in which contemporary rationales for educational inequality are linked to a…