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income inequality

Annalisa Saracino, Mauro Zaccarelli, Patrizia Lorenzini, Alessandra Bandera, Giulia Marchetti, Francesco Castelli, Andrea Gori, Enrico Girardi, Cristina Mussini, Paolo Bonfanti, Adriana Ammassari, Antonella d'Arminio Monforte
BACKGROUND: Social determinants are known to be a driving force of health inequalities, even in high income countries. Aim of our study was to determine if these factors can limit antiretroviral therapy (ART) access, outcome and retention in care of people living with HIV (PLHIV) in Italy. METHODS: All ART naïve HIV+ patients (pts) of Italian nationality enrolled in the ICONA Cohort from 2002 to 2016 were included. The association of socio-demographic characteristics (age, sex, risk factor for HIV infection, educational level, occupational status and residency area) with time to: ART initiation (from the first positive anti-HIV test), ART regimen discontinuation, and first HIV-RNA < 50 cp/mL, were evaluated by Cox regression analysis, Kaplan Meier method and log-rank test...
July 13, 2018: BMC Public Health
Paola A Mosquera, Miguel San Sebastian, Anneli Ivarsson, Per E Gustafsson
BACKGROUND: Socioeconomic inequalities in cardiovascular disease seem to widen or endure in Sweden. However, research on inequalities in antecedent cardiovascular risk factors (CVRFs), and particularly what underpins them, is scarce. The present study aimed 1) to estimate income-related inequalities in eight biological cardiovascular risk factors in Swedish middle-aged women and men; and 2) to examine the contribution of demographic, socioeconomic, behavioural and psychosocial determinants to the observed inequalities...
July 13, 2018: International Journal for Equity in Health
Katie Thomson, Frances Hillier-Brown, Adam Todd, Courtney McNamara, Tim Huijts, Clare Bambra
BACKGROUND: Socio-economic inequalities are associated with unequal exposure to social, economic and environmental risk factors, which in turn contribute to health inequalities. Understanding the impact of specific public health policy interventions will help to establish causality in terms of the effects on health inequalities. METHODS: Systematic review methodology was used to identify systematic reviews from high-income countries that describe the health equity effects of upstream public health interventions...
July 13, 2018: BMC Public Health
Javier Brazo-Sayavera, Gregore I Mielke, Pedro R Olivares, Luciano Jahnecka, Inacio Crochemore M Silva
Policymakers rely on information for describing and monitoring levels of physical activity among the population. However, in Uruguay there is no research presenting physical activity practices nationwide. The present study aims to describe the leisure time physical activity levels and their unequal distribution among Uruguayan adults. Data from the 2014 Uruguayan National Health Survey ( n = 3543 adults aged > 15 years) were analysed. Physical activity was measured by questionnaire, with participants reporting the number of days and time spent doing physical activity during leisure time in a typical week...
July 2, 2018: International Journal of Environmental Research and Public Health
Eleanor R Bull, Nicola McCleary, Xinru Li, Stephan U Dombrowski, Elise Dusseldorp, Marie Johnston
PURPOSE: Healthy eating, physical activity and smoking interventions for low-income groups may have small, positive effects. Identifying effective intervention components could guide intervention development. This study investigated which content and delivery components of interventions were associated with increased healthy behavior in randomised controlled trials (RCTs) for low-income adults. METHOD: Data from a review showing intervention effects in 35 RCTs containing 45 interventions with 17,000 participants were analysed to assess associations with behavior change techniques (BCTs) and delivery/context components from the template for intervention description and replication (TIDieR) checklist...
July 12, 2018: International Journal of Behavioral Medicine
Nan Zhang
BACKGROUND: China has seen rapid socio-economic changes and epidemiological transitions in the last few decades. Previous studies often fail to examine how wider macro-level forces contribute to changes in health inequality among its population in China. This study aims to examine urban/rural inequalities in cardiovascular (CVD) risks biomarkers among Chinese adolescents in two decades from 1991 to 2011 during the process of China's rapid urbanisation. METHODS: Data were drawn from a nationwide longitudinal dataset of the China Health and Nutrition Survey (CHNS) (Sweeps 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011)...
July 11, 2018: International Journal for Equity in Health
Alexander Kailembo, Raman Preet, Jennifer Stewart Williams
BACKGROUND: The 2015 Global Burden of Disease Study estimated that oral conditions affect 3.5 billion people worldwide with a higher burden among older adults and those who are socially and economically disadvantaged. Studies of inequalities in the use of oral health services by those in need have been conducted in high-income countries but evidence from low- and middle-income countries (LMICs) is limited. This study measures and describes socioeconomic inequality in self-reported unmet need for oral health services in adults aged 50 years and over, in China, Ghana and India...
July 11, 2018: International Journal for Equity in Health
Peter C Rockers, Richard O Laing, Veronika J Wirtz
Introduction: Wealth-based inequity in access to medicines is an impediment to achieving universal health coverage in many low-income and middle-income countries. We explored the relationship between household wealth and access to medicines for non-communicable diseases (NCDs) in Kenya. Methods: We administered a cross-sectional survey to a sample of patients prescribed medicines for hypertension, diabetes or asthma. Data were collected on medicines available in the home, including the location and cost of purchase...
2018: BMJ Global Health
A K Macmillan, H Mackie, J E Hosking, K Witten, M Smith, A Field, A Woodward, R Hoskins, J Stewart, B van der Werf, P Baas
BACKGROUND: Achieving a shift from car use to walking, cycling and public transport in cities is a crucial part of healthier, more environmentally sustainable human habitats. Creating supportive active travel environments is an important precursor to this shift. The longevity of urban infrastructure necessitates retrofitting existing suburban neighbourhoods. Previous studies of the effects of street changes have generally relied on natural experiments, have included few outcomes, and have seldom attempted to understand the equity impacts of such interventions...
July 9, 2018: BMC Public Health
Julia Moreira Pescarini, Agostino Strina, Joilda Silva Nery, Lacita Menezes Skalinski, Kaio Vinicius Freitas de Andrade, Maria Lucia F Penna, Elizabeth B Brickley, Laura C Rodrigues, Mauricio Lima Barreto, Gerson Oliveira Penna
Over 200,000 new cases of leprosy are detected each year, of which approximately 7% are associated with grade-2 disabilities (G2Ds). For achieving leprosy elimination, one of the main challenges will be targeting higher risk groups within endemic communities. Nevertheless, the socioeconomic risk markers of leprosy remain poorly understood. To address this gap we systematically reviewed MEDLINE/PubMed, Embase, LILACS and Web of Science for original articles investigating the social determinants of leprosy in countries with > 1000 cases/year in at least five years between 2006 and 2016...
July 9, 2018: PLoS Neglected Tropical Diseases
Martin Lukk, Erik Schneiderhan, Joanne Soares
Crowdfunding, the practice of asking for money from others using the Internet, is a major private means through which Canadians are funding their health care and education. Crowdfunding has proliferated in Canada during the 2010s and continues to grow, approaching the revenues of Canada's major traditional charities. Proponents describe it as an empowering practice from which anyone can benefit. If its gains are inequitably distributed, however, increasing reliance on this private funding mechanism, especially in core areas of welfare state provision, can further exacerbate inequalities of opportunity and income...
July 9, 2018: Canadian Review of Sociology, Revue Canadienne de Sociologie
Nelson Enrique Arias-Ortiz, Esther de Vries
Objective: To analyze differences in survival of breast, cervical, lung, prostate and stomach cancer by health insurance regime (HIR) and socioeconomic position (SEP) in an intermediate city in a middle-income country. Methods: All patients with breast, cervix uteri, lung, prostate and stomach cancer diagnosed between 2003 and 2007 and characterized by the Manizales population-based Cancer Registry (MCR) were included and followed up to a maximum of 5 years for identifying deaths...
March 30, 2018: Colombia Médica: CM
Miguel San Sebastián, Paola A Mosquera, Per E Gustafsson
Background: Three main explanations of the relationship between income and population health have been identified: the absolute, the contextual and the relative income hypotheses. The evidence about their relevance particularly in egalitarian societies is, however, inconsistent. This study aimed to test the three hypotheses in relation to psychological distress in northern Sweden. Methods: Data come from the 2014 cross-sectional survey from the four northern-most counties in Sweden, and included people aged 25-84 years (n = 21 004)...
July 5, 2018: European Journal of Public Health
Jeffrey Morgan, Olivier Ferlatte, Travis Salway, James Wilton, Mark Hull
OBJECTIVES: Pre-exposure prophylaxis (PrEP) is a highly effective, HIV prevention strategy increasingly being accessed by gay, bisexual, and other men who have sex with men (GBMSM). GBMSM face structural and individual-level barriers accessing PrEP, including awareness and cost. This paper assesses socio-demographic factors associated with awareness, interest, and willingness to pay for PrEP in a sample of Canadian GBMSM. METHODS: Data were derived from the 2015 Sex Now survey, a cross-sectional, online survey of GBMSM...
June 5, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Erin Pichora, Jane Y Polsky, Christina Catley, Nita Perumal, Jing Jin, Sara Allin
OBJECTIVES: The aims of this study were to examine (1) the concordance between income measured at the individual and area-based level and (2) the impact of using each measure of income on inequality estimates for three health indicators-the prevalence, respectively, of diabetes, smoking, and obesity. METHODS: Data for the health indicators and individual income among adults came from six cycles of the Canadian Community Health Survey (cycles 2003 through 2013). Area-based income was obtained by linking respondents' residential postal codes to neighbourhood income quintiles derived from the 2006 Canadian census...
May 7, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Naomi S Thulien, Denise Gastaldo, Stephen W Hwang, Elizabeth McCay
OBJECTIVES: The objective of this study was to provide an insider perspective on the experiences of nine formerly homeless young people as they transitioned into independent (market rent) housing and attempted to achieve meaningful social integration. METHODS: The study was conducted in Toronto, Canada, and guided by the conceptual framework developed for the World Health Organization by the Commission on Social Determinants of Health. A critical ethnographic methodology was used...
February 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Sarah Brennenstuhl
OBJECTIVES: Little is known about the nature of health inequalities present among women who are mothers of young children in Canada. Therefore, the purpose of the study is to identify dimensions of inequalities based on socio-economic position, race, partner status, and region and determine whether each type of inequality is independent of another. METHODS: Data are from the 2014 Canadian Community Health Survey. Women identifying as a parent living with a child ≤ 5 years, with complete data on the variables of interest, were selected (n = 2656)...
February 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Rosemary Morgan, Richard Mangwi Ayiasi, Debjani Barman, Stephen Buzuzi, Charles Ssemugabo, Nkoli Ezumah, Asha S George, Kate Hawkins, Xiaoning Hao, Rebecca King, Tianyang Liu, Sassy Molyneux, Kelly W Muraya, David Musoke, Tumaini Nyamhanga, Bandeth Ros, Kassimu Tani, Sally Theobald, Sreytouch Vong, Linda Waldman
BACKGROUND: Gender is often neglected in health systems, yet health systems are not gender neutral. Within health systems research, gender analysis seeks to understand how gender power relations create inequities in access to resources, the distribution of labour and roles, social norms and values, and decision-making. This paper synthesises findings from nine studies focusing on four health systems domains, namely human resources, service delivery, governance and financing. It provides examples of how a gendered and/or intersectional gender approach can be applied by researchers in a range of low- and middle-income settings (Cambodia, Zimbabwe, Uganda, India, China, Nigeria and Tanzania) to issues across the health system and demonstrates that these types of analysis can uncover new and novel ways of viewing seemingly intractable problems...
July 6, 2018: Health Research Policy and Systems
Elena S Rotarou, Dikaios Sakellariou
BACKGROUND: Preventive health services play a vital role in population health. However, access to such services is not always equitably distributed. In this article, we examine the barriers affecting utilisation rates of preventive health services, using Chile as a case study. METHODS: We conducted a cross-sectional study analysing secondary data from 206,132 Chilean adults, taken from the 2015 National Socioeconomic Characterisation Survey of the Government of Chile...
July 6, 2018: BMC Public Health
Cecilia Gustafsson
BACKGROUND: Nicaraguans have migrated internally and internationally for centuries due to economic, political and sociocultural factors. Deficiencies in the country's health care system have produced inequities in people's access to health care and medicines. Remittances have become an important source of income, partly invested in health. OBJECTIVES: The overall aim of the study was to analyse migration-health relations in contemporary Nicaragua within a broader context of socio-economic transformations...
2018: Global Health Action
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