Income-Based Disparities in Early Elementary School Science Achievement

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Curran, F. Chris

2017-01-01

This study documents gaps in kindergarten and first-grade science achievement by family income and explores the degree to which such gaps can be accounted for by student race/ethnicity, out-of-school activities, parental education, and school fixed effects. In doing so, it expands on prior research that documents disparate rates of science…

REGIONAL DISPARITIES – HISTORICAL CULTURAL INFLUENCES AND

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MARIA OŢIL

2015-08-01

Full Text Available In recent decades, the issue of regional disparities has become a highly debated topic, knowledge regarding regional disparities being a matter of political priority as their persistence hinders the appropriate integration process. On the other hand, emphasis was put on integration through the process of EU enlargement, thus highlighting other issues related to the nature and size of disparities. Regional disparities regarding development and the living standards of the population have long been the concern of all Member States. In the case of Romania, recently admitted into the European structures, registering large backlogs to economically developed countries, the intense mobilization of internal and external factors of economic growth in order to reduce and eliminate disparities compared to other countries, represents a clear necessity. The "European Union" (EU project is of an unprecedented complexity and scale because it involves a plurality of states, which are culturally and economically heterogeneous. Moreover, these economic and cultural differences exist even within the states. Hence, there is also the central idea of the Union, regarding unity in diversity. In Romania the local, regional communities have a strong identity, but still evolving. Taking into account Romania's objective of successfully integrating into European structures, and the principles of democratic decision-making requires that regional development should aim at reducing economic and social disparities based on a notable involvement of the local, regional communities. Based on these facts, the paper aims to present the current regional (and intra-regional disparities in Romania with regard to a number of synthetic indicators of capital, of labor and of outcomes. The persistence in time of these economic disparities can be explained by considering the cultural legacies – represented by norms, values, institutions, that impact on how people interact, communicate

Study of the relationship between the development level and degree of income inequality in the Russian regions

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Marina Yuryevna Malkina

2014-06-01

Full Text Available The subject of this article is the types of relationship between economic development and degree of income inequality in the regions of the Russian Federation. Research methods: testing the modified Kuznets hypothesis; relative deflating of regional parameters; calculating the differentiation and localization coefficients; constructing the Lorentz curves; correlation and regression analysis. Obtained results: 1 for Russian regions author discovered significant direct statistical relationship between the Gini and funds coefficients and the level of real per capita income with increasing returns, as well as less strong direct relationship between coefficients of differentiation mentioned above and the real GDP per capita with diminishing returns; 2 the “social wellbeing” coefficient is proposed and calculated for the regions, which based on localization index of real per capita income relative to the differentiation coefficient, and 3 the degree of interregional disparities in the Russian Federation is evaluated on the basis of the Gini coefficient, coefficient of variation and relative entropy for the nominal and real income and GRP per capita, and Lorenz curves for them are constructed. In this paper, author concluded: 1 presently the level of economic development of the Russian Federation regions negatively affects their income equality due to most of them are on the ascending branch of the S. Kuznets curve, 2 “social welfare” coefficient changes the positions of the middle-income regions more, than that of other regions, and 3 two factors have a positive impact on reducing the regional disparities: more ratio of total personal income to GRP in poor regions relative to rich ones (i.e. greater “social orientation” of poor regions, and positive correlation between income and the cost of living in the regions. The obtained results can be used by researchers in further testing the modified Kuznets hypothesis, as well as by local

The Impact of a Population-Based Screening Program on Income- and Immigration-Related Disparities in Colorectal Cancer Screening.

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Kiran, Tara; Glazier, Richard H; Moineddin, Rahim; Gu, Sumei; Wilton, Andrew S; Paszat, Lawrence

2017-09-01

Background: A population-based program promoting the Fecal Occult Blood Test (FOBT) for colorectal cancer screening was introduced in 2008 in Ontario, Canada, where opportunistic screening with colonoscopy had been increasing in frequency. We evaluated the impact of the program on income and immigration-related disparities in screening. Methods: We used linked administrative data to calculate colorectal cancer screening rates for eligible Ontarians in each year between 2001/02 ( n = 2,852,619) and 2013/14 ( n = 4,139,304). We quantified disparities using an "inequality ratio" of screening rates in the most disadvantaged group relative to the most advantaged group. We performed segmented logistic regression analyses stratified by screening modality and adjusted for age, sex, rurality, comorbidity, and morbidity. Results: Between 2001/02 and 2013/14, the income and immigration inequality ratios narrowed from 0.74 to 0.80 and 0.55 to 0.69, respectively. Before the screening program, the income inequality ratio was widening by 1% per year (95% CI 1% to 1%); in the year it was introduced, it narrowed by 4% (95% CI 2% to 7%) and in the years following, it remained stable [0% decrease (95% CI 1% decrease to 0% decrease) per year]. Results were similar for immigration-related disparities. After program introduction, disparities in receiving FOBT were narrowing at a faster rate while disparities in receiving colonoscopy were widening at a slower rate. Conclusions: Introduction of a population-based screening program promoting FOBT for colorectal cancer was associated with only modest improvements in immigration and income-related disparities. Impact: Reducing immigration and income-related disparities should be a focus for future research and policy work. Disparities in Ontario seem to be driven by a higher uptake of colonoscopy among more advantaged groups. Cancer Epidemiol Biomarkers Prev; 26(9); 1401-10. ©2017 AACR . ©2017 American Association for Cancer Research.

Appreciation of the Renminbi and Urban-Rural Income Disparity in China

OpenAIRE

Sylviane Guillaumont Jeanneney; Ping Hua

2008-01-01

Although poverty has been significantly decreasing in China over the last twenty years, this decrease has been highly unequal across the provinces and has brought increased disparity in urban and rural per capita income. We studied the impact of exchange rate policy on urban-rural per capita income, which was marked by strong real depreciation before 1994, followed by moderate appreciation before stabilizing. We concluded that in the inland provinces where poverty is hardest, real appreciatio...

Income Disparities in the Use of Health Screening Services Among University Students in Korea

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Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

2016-01-01

Abstract Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults’ socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea. This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables. Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87–1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30–2.34; Ptrend income level was 0.45 (0.31–0.66; Ptrend income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of

Gender and regional disparities of tuberculosis in Hunan, China.

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Chen, Mengshi; Kwaku, Abuaku Benjamin; Chen, Youfang; Huang, Xin; Tan, Hongzhuan; Wen, Shi Wu

2014-04-27

Major efforts have been made to improve the health care system in Hunan province, China. The aims of this study were to assess whether and to what extent these efforts have impacted on gender and regional disparities of Tuberculosis (TB) incidence in recent years, especially for less developed areas. We obtained data from the 2005-2009 China Information System for Disease Control and Prevention (CISDCP)to conduct this study in Hunan province. Counties within the province were divided into four regions according to quartiles based on the 2007 per capita GDP. Index of Disparity (ID) and Relative Index of Inequality (RII) were used to measure the disparities of TB incidence in relation to gender and region. Bootstrap technique was used to increase the precision. The average annual incidence of TB was 111.75 per 100,000 in males and 43.44 per 100 000 in females in Hunan. The gender disparity was stable, with ID from 42.34 in 2005 to 43.92 in 2009. For regional disparity, ID, RII (mean) and RII (ratio) decreased significantly from 2005 to 2009 in males (P China, regional disparity in relation to incidence of TB decreased significantly, but the gender disparity remains in the Hunan province.

Regional Disparities in Emissions of Rural Household Energy Consumption: A Case Study of Northwest China

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Wenheng Wu

2017-05-01

Full Text Available The purpose of this paper is to present the emissions status of multiple rural areas from the perspective of a field survey and make up for the defects of the traditional emission cognition of single type of area. The basic data in the lower reaches of the Weihe River of Northwest China were collected through household questionnaire surveys, and emissions from rural household energy consumption were calculated in the paper. In addition, the grey relational analysis method was used to identify influential factors of emission disparities. The results show that the total emissions of the plain, loess tableland, and Qinling piedmont areas are 1863.20, 1850.43, and 2556.68 kg, respectively. Regional disparities in emissions of rural household energy consumption vary greatly. CO2 emissions are highest in the Qinling piedmont area, followed by the loess tableland area. For other emissions, there is no fixed order of the three areas, which suggests that disparities in emissions are connected with the dominant type of energy consumption. Diversification of energy use might not necessarily produce higher emissions, but the traditional biomass energy pattern does generate more emissions. The regional supply capacity of household energy is the original influence factor of disparities in emissions, and factors that influence these disparities are directly related to differences among farmers, followed by the age structure, educational background, income level, occupation, and so on.

DISPARITIES OF THE REGIONS OF THE CZECH REPUBLIC IN TERMS OF TAX REVENUES

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Šárka Sobotovičová

2017-12-01

Full Text Available The paper deals with the issue of disparities in the tax revenue and yield coefficients of individual regions of the Czech Republic in the period from 2005 to 2014. The subject-matter of the research are the income taxes and the value-added tax, which are important tax revenues of public budgets and the source of financing of the regional and municipal budgets. For a comparison of the regions, the spot method is used. According to the results, the ranking of the regions is compiled. The spot method is based on the model region, which reaches the maximum values of a selected indicator. Furthermore, we calculated the indexes of revenues, along with yield coefficients of the value added tax as well as the corporate and personal income tax for each region. Tax revenues are affected in particular by legislative changes, but also by geographic, demographic and socio-economic differences among the regions. The authors have verified an assumption that individual regions have the same position in terms of both investigated variables. This assumption was not confirmed. It was found that the order of the regions for the examined variables was different. On the contrary, regions with a high share of tax revenues have low values in terms of tax yield coefficients.

Health disparities from economic burden of diabetes in middle-income countries: evidence from México.

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Armando Arredondo

Full Text Available The rapid growth of diabetes in middle-income countries is generating disparities in global health. In this context we conducted a study to quantify the health disparities from the economic burden of diabetes in México. Evaluative research based on a longitudinal design, using cost methodology by instrumentation. For the estimation of epidemiological changes during the 2010-2012 period, several probabilistic models were developed using the Box-Jenkins technique. The financial requirements were obtained from expected case management costs by disease and the application of an econometric adjustment factor to control the effects of inflation. Comparing the economic impact in 2010 versus 2012 (p<0.05, there was a 33% increase in financial requirements. The total amount for diabetes in 2011 (US dollars was $7.7 billion. It includes $3.4 billion in direct costs and $4.3 in indirect costs. The total direct costs were $.4 billion to the Ministry of Health (SSA, serving the uninsured population; $1.2 to the institutions serving the insured population (Mexican Institute for Social Security-IMSS-, and Institute for Social Security and Services for State Workers-ISSSTE-; $1.8 to users; and $.1 to Private Health Insurance (PHI. If the risk factors and the different health care models remain as they currently are in the analyzed institutions, health disparities in terms of financial implications will have the greatest impact on users' pockets. In middle-income countries, health disparities generated by the economic burden of diabetes is one of the main reasons for catastrophic health expenditure. Health disparities generated by the economic burden of diabetes suggests the need to design and review the current organization of health systems and the relevance of moving from biomedical models and curative health care to preventive and socio-medical models to meet expected challenges from diseases like diabetes in middle-income countries.

Income inequality widens the existing income-related disparity in depression risk in post-apartheid South Africa: Evidence from a nationally representative panel study.

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Burns, Jonathan K; Tomita, Andrew; Lund, Crick

2017-05-01

Income inequality (II) and poverty are major challenges in South Africa (SA) yet little is known about their interaction on population mental health. We explored relationships between district II, household income (HHI) and depressive symptoms in national panel data. We used 3 waves (2008, 2010, 2012) of the SA National Income Dynamics Study (n=25936) in adjusted mixed effects logistic regression to assess if the relationship between HHI and depressive symptoms is dependent on level of II. Depressive symptoms were assessed with Centre for Epidemiologic Studies Depression scale, and District inequality ratios (P10P90) derived from HHI distributions in 53 districts. Lower HHI and increasing II were associated with depressive symptoms. The interaction term between HHI and II on depressive symptoms was significant (β=0.01, 95% CI: income-related disparities in depression risk in SA, with policy implications for understanding socioeconomic determinants of mental health and informing global efforts to reduce disparities in high poverty and inequality contexts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Health & access to care among working-age lower income adults in the Great Recession: Disparities across race and ethnicity and geospatial factors.

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Towne, Samuel D; Probst, Janice C; Hardin, James W; Bell, Bethany A; Glover, Saundra

2017-06-01

In the United States (US) and elsewhere, residents of low resource areas face health-related disparities, and may experience different outcomes throughout times of severe economic flux. We aimed to identify individual (e.g. sociodemographic) and environmental (e.g. region, rurality) factors associated with self-reported health and forgone medical care due to the cost of treatment in the US across the Great Recession (2008-2009). We analyzed nationally representative data (2004-2010) using the Behavioral Risk Factor Surveillance System in the US. Individual and geospatial factors (rurality, census region) were used to identify differences in self-reported health and forgone medical care due to the cost. Adjusted-analyses taking into account individual and geospatial factors among those with incomes Recession were more likely to report forgone care than before the Recession. Having insurance and/or being employed (versus unemployed) was a protective factor in terms of reporting fair/poor health and having to forgo health care due to cost. Policies affecting improvements in health and access for vulnerable populations (e.g., low-income minority adults) are critical. Monitoring trends related to Social Determinants of Health, including the relationship between health and place (e.g. Census region, rurality), is necessary in efforts targeted towards ameliorating disparities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trends in Early Prenatal Care Among Women with Pre-Existing Diabetes: Have Income Disparities Changed?

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Breathett, Khadijah; Filley, Jessica; Pandey, Madhaba; Rai, Nayanjot; Peterson, Pamela N

2018-01-01

Women with pre-existing diabetes are at high maternal risk for comorbidities and death, particularly when early prenatal care is not received. Low income is a known barrier to early prenatal care. It is unknown whether recent policies to expand access to prenatal care have reduced income disparities. We hypothesized that income disparities would be minimized and that the odds of receipt of first trimester prenatal care among women with pre-existing diabetes would become similar across income strata over time. Using the Colorado birth certificate registry from 2007 to 2014, receipt of prenatal care was assessed retrospectively in 2,497 women with pre-existing diabetes. Logistic regression was used to examine the association between high (>$50,000), medium ($25,000-50,000), and low (prenatal care by birth year, adjusted for demographics. High, medium, and low income represented 29.5%, 19.0%, and 51.5% of the cohort, respectively. Women with high income were more likely to receive first trimester care than women with low income from 2007 [adjusted odds ratio, 95% confidence interval: 2.16 (1.18, 3.96)] through 2013 [1.66 (1.01, 2.73)], but significant differences were no longer observed in 2014 [1.59 (0.89, 2.84)]. The likelihood of receiving first trimester prenatal care was not significantly different between medium- and low-income strata from 2007 [1.07 (0.66, 1.74)] through 2014 [0.77 (0.48, 1.23)]. From 2007 to 2013, women in Colorado with diabetes were more likely to receive early prenatal care if they were in the highest income stratum than in the lowest stratum. In 2014, receipt of first trimester care became equitable across all income strata. Future work should examine national patterns of income with receipt of prenatal care and outcomes among women with pre-existing diabetes.

Earnings disparities and income inequality in CEE countries: an analysis of development and relationships

Czech Academy of Sciences Publication Activity Database

Večerník, Jiří

2012-01-01

Roč. 50, č. 3 (2012), s. 27-48 ISSN 0012-8775 R&D Projects: GA ČR(CZ) GAP404/11/1521 Institutional support: RVO:68378025 Keywords : earnings disparities * income inequality * CEE countries Subject RIV: AH - Economics Impact factor: 0.211, year: 2012

Can medical insurance coverage reduce disparities of income in elderly patients requiring long-term care? The case of the People's Republic of China.

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Zhang, Zhenyu; Wang, Jianbing; Jin, Mingjuan; Li, Mei; Zhou, Litao; Jing, Fangyuan; Chen, Kun

2014-01-01

The People's Republic of China's population is aging rapidly, partly because of the impact of the one-child policy and improvements in the health care system. Caring for bedridden seniors can be a challenge for many families in the People's Republic of China. To identify the inequality of income among different age groups and social statuses, and evaluate the medical burden and health insurance compensation in the People's Republic of China. We measured income inequality and insurance compensation levels among bedridden patients in Zhejiang province, People's Republic of China. Factor analysis and Gini coefficients were used to evaluate degree of income inequality and insurance compensation level. We found distinct regional disparities in Zhejiang province, including the aspects of income, expenses, and time. Gini coefficients of older adults with long-term care needs in urban and rural areas were 0.335 and 0.602, respectively. In all age groups, Gini coefficients increased after adjustment for medical expenditures, and the inequality persisted after insurance reimbursement was taken into consideration. A significant income disparity between rural and urban areas was observed. Inequality increased with age, and medical expenditure is a huge burden for older people with long-term care needs. Health insurance does not play an important role in reducing inequalities among patients who need long-term care services.

Can medical insurance coverage reduce disparities of income in elderly patients requiring long-term care? The case of the People’s Republic of China

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Zhang, Zhenyu; Wang, Jianbing; Jin, Mingjuan; Li, Mei; Zhou, Litao; Jing, Fangyuan; Chen, Kun

2014-01-01

Background The People’s Republic of China’s population is aging rapidly, partly because of the impact of the one-child policy and improvements in the health care system. Caring for bedridden seniors can be a challenge for many families in the People’s Republic of China. Objective To identify the inequality of income among different age groups and social statuses, and evaluate the medical burden and health insurance compensation in the People’s Republic of China. Methods We measured income inequality and insurance compensation levels among bedridden patients in Zhejiang province, People’s Republic of China. Factor analysis and Gini coefficients were used to evaluate degree of income inequality and insurance compensation level. Results We found distinct regional disparities in Zhejiang province, including the aspects of income, expenses, and time. Gini coefficients of older adults with long-term care needs in urban and rural areas were 0.335 and 0.602, respectively. In all age groups, Gini coefficients increased after adjustment for medical expenditures, and the inequality persisted after insurance reimbursement was taken into consideration. Conclusion A significant income disparity between rural and urban areas was observed. Inequality increased with age, and medical expenditure is a huge burden for older people with long-term care needs. Health insurance does not play an important role in reducing inequalities among patients who need long-term care services. PMID:24855346

Absence of race- or gender-specific income disparities among full-time white and Asian general internists working for the Veterans Administration.

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Weeks, William B; Wallace, Amy E

2010-02-01

Gender-based, but not race-based, income disparities exist among general internists who practice medicine in the private sector. The aim of this study was to assess whether race- or gender-based income disparities existed among full-time white and Asian general internists who worked for the Veterans Health Administration of the US Department of Veterans Affairs (VA) between fiscal years 2004 and 2007, and whether any disparities changed after the VA enacted physician pay reform in early 2006. A retrospective study was conducted of all nonsupervisory, board-certified, full-time white or Asian VA general internists who did not change their location of practice between fiscal years 2004 and 2007. A longitudinal cohort design and linear regression modeling, adjusted for physician characteristics, were used to compare race- and gender-specific incomes in fiscal years 2004-2007. A total of 176 physicians were included in the study: 82 white males, 33 Asian males, 30 white females, and 31 Asian females. In all fiscal years examined, white males had the highest mean annual incomes, though not statistically significantly so. Regression analyses for fiscal years 2004 through 2006 revealed that physician age and years of service were predictive of total income. After physician pay reform was enacted, Asian male VA primary care physicians had higher annual incomes than did physicians in all other race or gender categories, after adjustment for age and years of VA service, though these differences were not statistically significant. No significant gender-based income disparities were noted among these white and Asian VA physicians. Our findings for white and Asian general internists suggest that the VA' s goal of maintaining a racially diverse workforce may have been effected, in part, through use of market pay among primary care general internists. Copyright 2010. Published by Elsevier Inc.

Konference Regionálne disparity v Strednej Európe

Czech Academy of Sciences Publication Activity Database

Vajdová, Zdenka

2007-01-01

Roč. 43, č. 5 (2007), s. 1071-1072 ISSN 0038-0288. [Regionálne disparity v Strednej Európe. Bratislava, 25.10.2007-26.10.2007] R&D Projects: GA MŠk 2D06001 Institutional research plan: CEZ:AV0Z70280505 Keywords : regional disparities * regional policy * international conference Subject RIV: AO - Sociology, Demography Impact factor: 0.169, year: 2007

The energy implications of Chinese regional disparities

International Nuclear Information System (INIS)

Huang Yuanxi; Todd, Daniel

2010-01-01

Chinese regional disparities are readily apparent, with well-being seen the highest at the coast and declining steadily inland. Their mitigation will clearly be hostage to improvement in economic development, since the unevenness of that development created them in the first place. Integral to development is structural change, and the key to effecting that change is improved energy efficiency. Indeed, this paper explores energy usage and regional development from 1952 to the present, establishing that they both conform to an inverted-U pattern. Eastern China, the leader in industrialization, has moved beyond the apogee of the curve, but Central and Western China have failed to follow suit, being held back by poor industrial structures and adverse patterns of energy consumption. Remedying this laggardly performance preoccupies China's Government, for rendering the country energy-efficient and containing regional disparities, both rest on pushing the Central and Western regions down the curve in the wake of the prosperous coast.

Income Inequalities, Productive Structure and Macroeconomic Dynamics. A Regional Approach to the Russian Case

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Julien Vercueil

2016-07-01

Full Text Available During the past decades, sustained economic growth in emerging countries (and among them, BRICS countries has attracted much attention in the western world. Multinational companies have been lured by the growing purchasing power of a significant part of the population, often presented as the “promised land” of consumer spending in durable goods, high tech services and fashion products. Of course, increasing incomes imply also significant socio-economic changes within these countries as well. A growing number of studies have been carried in order to track the evolution of income distribution in BRICS countries, and the formation and composition of a social group usually called “middle class” in western countries (Kharas (2010, SIEMS (2010, Levada (2012, Ernst and Young (2013, Kochhar R., Oates R. (2015. In this paper we try to assess the impact of recent macroeconomic fluctuations on Russian households income levels. We analyse the Russian trajectory in three different ways. First, we compare the evolution of the “middle class” in Russia with other (BRIC and western countries, using the wealthbased definition of this group proposed in the Global Wealth Report (Crédit Suisse Research Institute, 2015. Second, we go deeper into the Russian case in order to show how regional disparities regarding incomes distribution can be interpreted, considering the country’s recent macroeconomic trajectory. For this purpose, we build a productive typology of the Russian regions and study the link between each type and the level of income inequalities, using the varying structures in sources of household’s incomes as a possible explanation of regional variations. We conclude by an assessment of the remaining challenges for incomes policy in Russia

Gender disparities in completing school education in India: Analyzing regional variations

OpenAIRE

Husain, Zakir

2010-01-01

Is gender disparity greater in North India? This paper seeks to answer this question by examining gender differences in probability of completing school education across regions in India. A Gender Disparity Index is calculated using National Sample Survey Organization unit level data from the 61st Round and regional variations in this index analyzed to examine the hypothesis that gender disparity is greater in the North, comparative to the rest of India. This is followed by an econometric exe...

Regional Disparities in Online Map User Access Volume and Determining Factors

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Li, R.; Yang, N.; Li, R.; Huang, W.; Wu, H.

2017-09-01

The regional disparities of online map user access volume (use `user access volume' in this paper to indicate briefly) is a topic of growing interest with the increment of popularity in public users, which helps to target the construction of geographic information services for different areas. At first place we statistically analysed the online map user access logs and quantified these regional access disparities on different scales. The results show that the volume of user access is decreasing from east to the west in China as a whole, while East China produces the most access volume; these cities are also the crucial economic and transport centres. Then Principal Component Regression (PCR) is applied to explore the regional disparities of user access volume. A determining model for Online Map access volume is proposed afterwards, which indicates that area scale is the primary determining factor for regional disparities, followed by public transport development level and public service development level. Other factors like user quality index and financial index have very limited influence on the user access volume. According to the study of regional disparities in user access volume, map providers can reasonably dispatch and allocate the data resources and service resources in each area and improve the operational efficiency of the Online Map server cluster.

PERFORMANCE AND DEVELOPMENT LEVEL - COMPARATIVE ANALYSIS OF DISPARITIES AMONG REGIONS OF DEVELOPMENT AND MACRO-REGIONS IN ROMANIA

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MARIA OŢIL

2015-03-01

Full Text Available The major challenge of the regional policies is to mitigate the social and economic disparities between different territories and regions. The immediate reality shows that this is a problem which is neither simple nor for short term. For Romania, which has large lags behind compared to the economically developed countries, the intense mobilization of internal and external factors of economic growth in order to reduce and eliminate disparities compared to other countries, is a definite necessity, a regularity resulting from regional and national interests in terms of its finality - the welfare of society. The economic crisis has increased regional disparities in the European Union countries, these especially affecting the countries which are less economically efficient. The present research aims at accomplishing a comparative analysis regarding disparities among regions of development and macro-regions of Romania in order to assess the performance of the productive sector, of the structural types of economies and of their level of development.

Pulmonary Embolism Mortality in Brazil from 1989 to 2010: Gender and Regional Disparities.

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Darze, Eduardo Sahade; Casqueiro, Juliana Borges; Ciuffo, Luisa Allen; Santos, Jessica Mendes; Magalhães, Iuri Resedá; Latado, Adriana Lopes

2016-01-01

A significant variation in pulmonary embolism (PE) mortality trends have been documented around the world. We investigated the trends in mortality rate from PE in Brazil over a period of 21 years and its regional and gender differences. Using a nationwide database of death certificate information we searched for all cases with PE as the underlying cause of death between 1989 and 2010. Population data were obtained from the Brazilian Institute of Geography and Statistics (IBGE). We calculated age-, gender- and region-specific mortality rates for each year, using the 2000 Brazilian population for direct standardization. Over 21 years the age-standardized mortality rate (ASMR) fell 31% from 3.04/100,000 to 2.09/100,000. In every year between 1989 and 2010, the ASMR was higher in women than in men, but both showed a significant declining trend, from 3.10/100,000 to 2.36/100,000 and from 2.94/100,000 to 1.80/100,000, respectively. Although all country regions showed a decline in their ASMR, the largest fall in death rates was concentrated in the highest income regions of the South and Southeast Brazil. The North and Northeast regions, the lowest income areas, showed a less marked fall in death rates and no distinct change in the PE mortality rate in women. Our study showed a reduction in the PE mortality rate over two decades in Brazil. However, significant variation in this trend was observed amongst the five country regions and between genders, pointing to possible disparities in health care access and quality in these groups.

Rural Urban Disparity in and around Surabaya Region, Indonesia

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Vely Kukinul Siswanto

2014-12-01

Full Text Available A shift in development towards the outskirts of urban areas changes the characteristics of the region and can ultimately lead to urban disparities in economic and social terms. The current study has tried to divide the study area covers the areas of surrounding Surabaya as urban, peri urban and rural areas with reference to three time periods (2008, 2009 and 2010 and shows that the typology in the study area changes each year. Furthermore, based on the theil index analysis, using a number of pre-prosperous household for social disparity and per capita GDP (Gross Domestic Product for economic disparity shows that urban and peri urban areas have medium and high level of social and economic disparity compare with rural area which have low levels of disparity. Through multivariate correlation analysis can be seen that the health center distance, electricity and water users effecting the social disparity. Moreover, the financial, industrial, electricity, trade, construction, transportation, agriculture, and mining sector's productivity have a significant relationship with the economic disparity. Health facilities, water and electricity improvement strategies to be followed for reducing the social disparity. Electricity improvement, water, services sector, transportation infrastructure, and industrial development to reduce the economic disparity.

Regional Economic Growth; Socio-Economic Disparities among Counties

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Salih Özgür SARICA

2014-12-01

Full Text Available State level economy has always been relying on its major metropolitan area’s economic success. So, such metropolitan agglomerations have been considered the only agents that can foster the state’s economic standing as if other economic places do (or may not have significant contribution to the regional economy. In contrast, as some major cities enhance their economic well-being and agglomerate in specialized sector, the rest of the region lose their economic grounds or stay constant by widening the economic gap among cities. Therefore, an institutional approach can help to establish new regional arrangements to substitute all economic places to coordinate each other and succeed the economic growth as part of state government by reducing the disparities. In this sense, this study builds upon the inquiry that seeks the impacts of some economic disparities among economic places (counties on the performances of state level regional economy.

Income-related health inequalities across regions in Korea

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Ahn Byung

2011-10-01

Full Text Available Abstract Introduction In addition to economic inequalities, there has been growing concern over socioeconomic inequalities in health across income levels and/or regions. This study measures income-related health inequalities within and between regions and assesses the possibility of convergence of socioeconomic inequalities in health as regional incomes converge. Methods We considered a total of 45,233 subjects (≥ 19 years drawn from the four waves of the Korean National Health and Nutrition Examination Survey (KNHANES. We considered true health as a latent variable following a lognormal distribution. We obtained ill-health scores by matching self-rated health (SRH to its distribution and used the Gini Coefficient (GC and an income-related ill-health Concentration Index (CI to examine inequalities in income and health, respectively. Results The GC estimates were 0.3763 and 0.0657 for overall and spatial inequalities, respectively. The overall CI was -0.1309, and the spatial CI was -0.0473. The spatial GC and CI estimates were smaller than their counterparts, indicating substantial inequalities in income (from 0.3199 in Daejeon to 0.4233 Chungnam and income-related health inequalities (from -0.1596 in Jeju and -0.0844 in Ulsan within regions. The results indicate a positive relationship between the GC and the average ill-health and a negative relationship between the CI and the average ill-health. Those regions with a low level of health tended to show an unequal distribution of income and health. In addition, there was a negative relationship between the GC and the CI, that is, the larger the income inequalities, the larger the health inequalities were. The GC was negatively related to the average regional income, indicating that an increase in a region's average income reduced income inequalities in the region. On the other hand, the CI showed a positive relationship, indicating that an increase in a region's average income reduced health

Regional features of the individual income tax

Directory of Open Access Journals (Sweden)

L. V. Demina

2016-01-01

Full Text Available Tax on income of physical persons according to the method of establishing refers to federal taxes, however, is the establishment of a regional peculiarities. Currently, in accordance with the distribution of taxes between the budgets of the order, the share of this tax in the regional budgets is directly dependent on the level and income level received by the population, to carry on activity in a particular area of the country. The article discusses the possibility of impact on the taxation of income of different categories of individuals from the regions. Since the tax on personal income has expressed toms-social orientation, in the Tax Code of the Russian Federation provided for the regions eligible for the establishment of a number of benefits for certain categories of taxpayers. This article describes the possible impact on the taxation of income of different categories of individuals from the regions by establishing incentives. The issues of granting tariff preferences income owners of private farms on the example of the Moscow region. An important social task of the state related to the support of family and birth rate increase, which is be implemented in the Russian Federation in the framework of the tax on personal income, is exemption from personal income tax funds regional maternal (family capital. The regional legislation can be traced virtually the same position on the determination of the number of children in the case of birth (adoption of which the inhabitants of the region there is a right to additional measures of state support and tax benefits. The data on the size of the analysis of the results of the regional maternity capital and the terms of its provision. We describe the benefits that the regions were able to provide 2016 individuals - payers of personal income tax on income from the sale of real estate. We consider the benefits that are currently install or may be establish by laws of subjects of federation in the

Gender Disparities in the Food Insecurity-Overweight and Food Insecurity-Obesity Paradox among Low-Income Older Adults.

Science.gov (United States)

Hernandez, Daphne C; Reesor, Layton; Murillo, Rosenda

2017-07-01

Obesity and obesity-related comorbidities are increasing among older adults. Food insecurity is a nutrition-related factor that coexists with obesity among low-income individuals. The majority of the research on the food insecurity-obesity paradox has been conducted on low-income mothers and children, with research lacking on large diverse samples of older adults. The purpose of this study was to assess gender disparities in the association between food insecurity and overweight and obesity among low-income older adults. Cross-sectional 2011 and 2012 National Health Interview Survey data were used. Food insecurity status was determined by ≥3 affirmative responses on the 10-item US Department of Agriculture Food Security Scale (FSS). Body mass index (BMI) was calculated as outlined by the Centers for Disease Control and Prevention based on self-reported height and weight. Adults included were low-income (≤1.99 federal poverty level [FPL]), older (aged ≥60 years), with a normal BMI (18.5) or greater who had complete data on FSS, BMI, and the following covariates: age, race or ethnicity, marital status, income, nativity status, physical activity, poor health status, health insurance coverage, problems paying medical bills or for medicine, and region of residency (N=5,506). Multivariate logistic regression models were stratified by gender to estimate the association between food insecurity and higher weight status. All models included covariates. In covariate-adjusted models, compared with low-income, food secure men, low-income, food-insecure men had 42% and 41% lower odds of being overweight and overweight or obese, respectively. Despite the high prevalence rate of obesity among low-income, food-insecure women, food insecurity was not significantly related to overweight, obesity, or overweight or obesity for older adult women in adjusted models. Food insecurity-overweight and -obesity paradox appears not to be present in older men. However, food insecurity and

Pulmonary Embolism Mortality in Brazil from 1989 to 2010: Gender and Regional Disparities

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Eduardo Sahade Darze

2015-01-01

Full Text Available AbstractBackground:A significant variation in pulmonary embolism (PE mortality trends have been documented around the world. We investigated the trends in mortality rate from PE in Brazil over a period of 21 years and its regional and gender differences.Methods:Using a nationwide database of death certificate information we searched for all cases with PE as the underlying cause of death between 1989 and 2010. Population data were obtained from the Brazilian Institute of Geography and Statistics (IBGE. We calculated age-, gender- and region-specific mortality rates for each year, using the 2000 Brazilian population for direct standardization.Results:Over 21 years the age-standardized mortality rate (ASMR fell 31% from 3.04/100,000 to 2.09/100,000. In every year between 1989 and 2010, the ASMR was higher in women than in men, but both showed a significant declining trend, from 3.10/100,000 to 2.36/100,000 and from 2.94/100,000 to 1.80/100,000, respectively. Although all country regions showed a decline in their ASMR, the largest fall in death rates was concentrated in the highest income regions of the South and Southeast Brazil. The North and Northeast regions, the lowest income areas, showed a less marked fall in death rates and no distinct change in the PE mortality rate in women.Conclusions:Our study showed a reduction in the PE mortality rate over two decades in Brazil. However, significant variation in this trend was observed amongst the five country regions and between genders, pointing to possible disparities in health care access and quality in these groups.

Night lights and regional income inequality in Africa

DEFF Research Database (Denmark)

Mveyange, Anthony Francis

Estimating regional income inequality in Africa has been challenging due to the lack of reliable and consistent sub-national income data. I employ night lights data to circumvent this limitation. I find significant and positive associations between regional inequality visible through night lights...... and income in Africa. Thus, in the absence of income data, we can construct regional inequality proxies using night lights data. Further investigation on the night lights-based regional inequality trends reveals two main findings: first, increasing regional inequality trends between 1992 and 2003; and second......, declining regional inequality trends between 2004 and 2012....

Trends in Disparities in Low-Income Children's Health Insurance Coverage and Access to Care by Family Immigration Status.

Science.gov (United States)

Jarlenski, Marian; Baller, Julia; Borrero, Sonya; Bennett, Wendy L

2016-03-01

To examine time trends in disparities in low-income children's health insurance coverage and access to care by family immigration status. We used data from the National Survey of Children's Health in 2003 to 2011-2012, including 83,612 children aged 0 to 17 years with family incomes immigration status categories: citizen children with nonimmigrant parents; citizen children with immigrant parents; and immigrant children. We used multivariable regression analyses to obtain adjusted trends in health insurance coverage and access to care. All low-income children experienced gains in health insurance coverage and access to care from 2003 to 2011-2012, regardless of family immigration status. Relative to citizen children with nonimmigrant parents, citizen children with immigrant parents had a 5 percentage point greater increase in health insurance coverage (P = .06), a 9 percentage point greater increase in having a personal doctor or nurse (P Immigrant children had significantly lower health insurance coverage than other groups. However, the group had a 14 percentage point greater increase in having a personal doctor or nurse (P immigration status have lessened over time among children in low-income families, although large disparities still exist. Policy efforts are needed to ensure that children of immigrant parents and immigrant children are able to access health insurance and health care. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

CHINA'S INTERNATIONAL TOURISM UNDER ECONOMIC TRANSITION: NATIONAL TRENDS AND REGIONAL DISPARITIES

OpenAIRE

Liang, Chyi-Lyi (Kathleen); Guo, Rong; Wang, Qingbin

2003-01-01

China's Tourism industry, especially international tourism, has expanded rapidly since its market-oriented economic reform started in 1978. There has been limited information regarding the trends and regional disparities. This paper examines the national trends of China's international tourism since 1982 and analyzes the changes in regional disparities since 1995. While the trend analysis suggests that China's international tourism is likely to keep growing at a significant rate, the analysis...

Environmental supports for walking/biking and traffic safety: income and ethnicity disparities.

Science.gov (United States)

Yu, Chia-Yuan

2014-10-01

The present study investigates the influence of income, ethnicity, and built environmental characteristics on the percentages of workers who walk/bike as well as on pedestrian/cyclist crash rates. Furthermore, income and ethnicity disparities are also explored. This study chose 162 census tracts in Austin as the unit of analysis. To explore income and ethnicity differences in built environments, this study examined the associations of the poverty rate, the percentage of white population, and the percentage of Hispanic population to each built environmental variable. Path models were applied to examine environmental supports of walking/biking and pedestrian/cyclist safety. Areas with high poverty rates had more biking trips and experienced more cyclist crashes, while areas with a high percentage of white population generated more walking trips and fewer pedestrian crashes. Sidewalk completeness and mixed land uses promoted walking to work but increased the crash risk for pedestrians as well. In terms of biking behaviors, road density and transit stop density both increased biking trips and cyclist crashes. Environmental designs that both encourage walking/biking trips and generate more safety threats should attract more attention from policy makers. Policies should also be more devoted to enhancing the mobility and health for areas with high poverty rates. Copyright © 2014 Elsevier Inc. All rights reserved.

Can medical insurance coverage reduce disparities of income in elderly patients requiring long-term care? The case of the People’s Republic of China

Directory of Open Access Journals (Sweden)

Zhang ZY

2014-05-01

Full Text Available Zhenyu Zhang,1 Jianbing Wang,1 Mingjuan Jin,1 Mei Li,1 Litao Zhou,2 Fangyuan Jing,1 Kun Chen1 1Department of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, Zhejiang, People’s Republic of China; 2Quality Control Department, Zhejiang Hospital, Zhejiang, People’s Republic of China Background: The People’s Republic of China’s population is aging rapidly, partly because of the impact of the one-child policy and improvements in the health care system. Caring for bedridden seniors can be a challenge for many families in the People’s Republic of China.Objective: To identify the inequality of income among different age groups and social statuses, and evaluate the medical burden and health insurance compensation in the People’s Republic of China.Methods: We measured income inequality and insurance compensation levels among bedridden patients in Zhejiang province, People’s Republic of China. Factor analysis and Gini coefficients were used to evaluate degree of income inequality and insurance compensation level.Results: We found distinct regional disparities in Zhejiang province, including the aspects of income, expenses, and time. Gini coefficients of older adults with long-term care needs in urban and rural areas were 0.335 and 0.602, respectively. In all age groups, Gini coefficients increased after adjustment for medical expenditures, and the inequality persisted after insurance reimbursement was taken into consideration.Conclusion: A significant income disparity between rural and urban areas was observed. Inequality increased with age, and medical expenditure is a huge burden for older people with long-term care needs. Health insurance does not play an important role in reducing inequalities among patients who need long-term care services. Keywords: Gini coefficient, bedridden, long-term care, insurance

Regional socioeconomic disparities in outcomes for workers with low back pain in the United States.

Science.gov (United States)

Shraim, Mujahed; Cifuentes, Manuel; Willetts, Joanna L; Marucci-Wellman, Helen R; Pransky, Glenn

2017-05-01

Although regional socioeconomic (SE) factors have been associated with worse health outcomes, prior studies have not addressed important confounders or work disability. A national sample of 59 360 workers' compensation (WC) cases to evaluate impact of regional SE factors on medical costs and length of disability (LOD) in occupational low back pain (LBP). Lower neighborhood median household incomes (MHI) and higher state unemployment rates were associated with longer LOD. Medical costs were lower in states with more workers receiving Social Security Disability, and in areas with lower MHI, but this varied in magnitude and direction among neighborhoods. Medical costs were higher in more urban, more racially diverse, and lower education neighborhoods. Regional SE disparities in medical costs and LOD occur even when health insurance, health care availability, and indemnity benefits are similar. Results suggest opportunities to improve care and disability outcomes through targeted health care and disability interventions. © 2017 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Balancing regional industrial development: analysis on regional disparity of China's industrial emissions and policy implications

DEFF Research Database (Denmark)

Liang, Hanwei; Dong, Liang; Luo, Xiao

2016-01-01

Efficient industrial emissions mitigation strategy is critical for China's national action on climate change and sustainable development, considering its rapid industrialization. Regional disparity brings difficulties and uncertainties to policy implementation in China. Therefore, an investigation...... development, and highlight not only disparity, but also inequity exists. It is concluded that, there is a larger unequal distribution of GDP per unit of air pollutants and CO2 emission between eastern and western regions, reveals that less developed western and central regions suffer from the emission leakage...... on the regional features of industrial emissions is critical to better decision makings. While to date, related studies have been rather few. This paper applies a spatial analysis on regional features of China's industrial emissions (SO2, NOx and PM2.5 and CO2 emission) in 31 provinces. Spatial autocorrelation...

Trends in racial/ethnic and income disparities in foods and beverages consumed and purchased from stores among US households with children, 2000-2013.

Science.gov (United States)

Ng, Shu Wen; Poti, Jennifer M; Popkin, Barry M

2016-09-01

It is unclear whether racial/ethnic and income differences in foods and beverages obtained from stores contribute to disparities in caloric intake over time. We sought to determine whether there are disparities in calories obtained from store-bought consumer packaged goods (CPGs), whether brands (name brands compared with private labels) matter, and if disparities have changed over time. We used NHANES individual dietary intake data among households with children along with the Nielsen Homescan data on CPG purchases among households with children. With NHANES, we compared survey-weighted energy intakes for 2003-2006 and 2009-2012 from store and nonstore sources by race/ethnicity [non-Hispanic whites (NHWs), non-Hispanic blacks (NHBs), and Hispanic Mexican-Americans) and income [≤185% federal poverty line (FPL), 186-400% FPL, and >400% FPL]. With the Nielsen data, we compared 2000-2013 trends in calories purchased from CPGs (obtained from stores) across brands by race/ethnicity (NHW, NHB, and Hispanic) and income. We conducted random-effect models to derive adjusted trends and differences in calories purchased (708,175 observations from 64,709 unique households) and tested whether trends were heterogeneous by race/ethnicity or income. Store-bought foods and beverages represented the largest component of dietary intake, with greater decreases in energy intakes in nonstore sources for foods and in store sources for beverages. Beverages from stores consistently decreased in all subpopulations. However, in adjusted models, reductions in CPG calories purchased in 2009-2012 were slower for NHB and low-income households than for NHW and high-income households, respectively. The decline in calories from name-brand food purchases was slower among NHB, Hispanic, and lowest-income households. NHW and high-income households had the highest absolute calories purchased in 2000. Across 2 large data sources, we found decreases in intake and purchases of beverages from stores

Territorial differentiation of incomes adjusted for inflation

Directory of Open Access Journals (Sweden)

Marina Valeryevna, Moroshkina

2017-06-01

Full Text Available Objective to analyze and evaluate the regional disparities of socioeconomic development of the Russian regions in terms of income differentiation adjusted for the level of inflation. Methods indicator by which to measure the level of regional growth heterogeneity is Gini coefficient allowing to determine the degree of the Russian regionsrsquo deviation from absolute equality. The unique feature of the authorrsquos approach is the calculation and analysis of the Gini coefficient not only in current prices but also in comparable prices of 1991. Thus the comparison of the Gini coefficient in terms of quotper capita incomequot in the period from 1991 to 2013 in comparable and current prices allows to estimate the impact of changes in the prices level on the dynamics of regional development. Results the article states that the regions differentiation by the level of economic development determines the necessity of considering this factor in economic policy areas. In these circumstances the analysis of income differentiation of the Russian regions has to take the impact of inflation into account. The article reviews the Russian and foreign research in the sphere of the income differentiation. Significant scientific interest to the problem of regional inequality is obvious over the past several decades. Approaches and methods of assessing the level of regional disparities are systematized as well as its key performance indicators. To assess the level of differentiation of Russian regions we used the Gini coefficient which was calculated not only by current but also by comparable prices. The calculation was carried out basing on the recalculation of the per capita income using the consumer price index. In the framework of the analysis the calculated Gini coefficient for per capita income by current and integrated prices allowed to observe the differential behavior of this indicator. In terms of quotper capita incomequot by current prices there is a

Income inequality in today's China.

Science.gov (United States)

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.

Income Disparities in the Use of Health Screening Services Among University Students in Korea: A Cross-Sectional Study of 2479 Participants in a University.

Science.gov (United States)

Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

2016-05-01

Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults' socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea.This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables.Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87-1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30-2.34; Ptrend income level was 0.45 (0.31-0.66; Ptrend income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on

Trends in racial/ethnic and income disparities in foods and beverages consumed and purchased from stores among US households with children, 2000–201312

Science.gov (United States)

Poti, Jennifer M; Popkin, Barry M

2016-01-01

Background: It is unclear whether racial/ethnic and income differences in foods and beverages obtained from stores contribute to disparities in caloric intake over time. Objective: We sought to determine whether there are disparities in calories obtained from store-bought consumer packaged goods (CPGs), whether brands (name brands compared with private labels) matter, and if disparities have changed over time. Design: We used NHANES individual dietary intake data among households with children along with the Nielsen Homescan data on CPG purchases among households with children. With NHANES, we compared survey-weighted energy intakes for 2003–2006 and 2009–2012 from store and nonstore sources by race/ethnicity [non-Hispanic whites (NHWs), non-Hispanic blacks (NHBs), and Hispanic Mexican-Americans) and income [≤185% federal poverty line (FPL), 186–400% FPL, and >400% FPL]. With the Nielsen data, we compared 2000–2013 trends in calories purchased from CPGs (obtained from stores) across brands by race/ethnicity (NHW, NHB, and Hispanic) and income. We conducted random-effect models to derive adjusted trends and differences in calories purchased (708,175 observations from 64,709 unique households) and tested whether trends were heterogeneous by race/ethnicity or income. Results: Store-bought foods and beverages represented the largest component of dietary intake, with greater decreases in energy intakes in nonstore sources for foods and in store sources for beverages. Beverages from stores consistently decreased in all subpopulations. However, in adjusted models, reductions in CPG calories purchased in 2009–2012 were slower for NHB and low-income households than for NHW and high-income households, respectively. The decline in calories from name-brand food purchases was slower among NHB, Hispanic, and lowest-income households. NHW and high-income households had the highest absolute calories purchased in 2000. Conclusions: Across 2 large data sources, we found

Racial/Ethnic and Income Disparities in Child and Adolescent Exposure to Food and Beverage Television Ads across U.S. Media Markets

OpenAIRE

Powell, Lisa M.; Wada, Roy; Kumanyika, Shiriki K.

2014-01-01

Obesity prevalence and related health burdens are greater among U.S. racial/ethnic minority and low-income populations. Targeted advertising may contribute to disparities. Designated market area (DMA) spot television ratings were used to assess geographic differences in child/adolescent exposure to food-related advertisements based on DMA-level racial/ethnic and income characteristics. Controlling for unobserved DMA-level factors and time trends, child/adolescent exposure to food-related ads,...

Racial/Ethnic and Income Disparities in Child and Adolescent Exposure to Food and Beverage Television Ads across U.S. Media Markets

Science.gov (United States)

Powell, Lisa M.; Wada, Roy; Kumanyika, Shiriki K.

2015-01-01

Obesity prevalence and related health burdens are greater among U.S. racial/ethnic minority and low-income populations. Targeted advertising may contribute to disparities. Designated market area (DMA) spot television ratings were used to assess geographic differences in child/adolescent exposure to food-related advertisements based on DMA-level racial/ethnic and income characteristics. Controlling for unobserved DMA-level factors and time trends, child/adolescent exposure to food-related ads, particularly for sugar-sweetened beverages and fast-food restaurants, was significantly higher in areas with higher proportions of black children/adolescents and lower-income households. Geographically targeted TV ads are important to consider when assessing obesity-promoting influences in black and low-income neighborhoods. PMID:25086271

Economic disparities between EU states and regions

Directory of Open Access Journals (Sweden)

Ion CIUREA

2010-05-01

Full Text Available EU has 27 Member States representing a community and a market of 493million citizens, which creates further economic and social disparities between thestates and their 271 regions. In a region in four, the GDP (gross domestic product percapita is 75% below the average for the EU-27. Based on the concepts of solidarity andcohesion, regional policy of the European Union favors reducing structural disparitiesbetween EU regions, the balanced development of the community and promoting aneffective equality of opportunity between people. Over the past 50 years, Europeancooperation has helped build highways, sewage plants, bridges, laboratories forbiotechnology. She helped to revive urban areas and neglected activities, throughcountless projects in the poorest regions of the Union.. Two key values: solidarity andcohesion, underlying these projects and the regional policy of the European Union. Theeconomic, social and territorial cohesion will always be at the heart of Europe Strategy2020, a key mechanism for achieving the priorities for a smart growth, sustainable andinclusive in the Member States and regions.

Out-of-pocket financial burden for low-income families with children: socioeconomic disparities and effects of insurance.

Science.gov (United States)

Galbraith, Alison A; Wong, Sabrina T; Kim, Sue E; Newacheck, Paul W

2005-12-01

To determine whether socioeconomic disparities exist in the financial burden of out-of-pocket (OOP) health care expenditures for families with children, and whether health insurance coverage decreases financial burden for low-income families. The Household Component of the 2001 Medical Expenditure Panel Survey. Cross-sectional family-level analysis. We used bivariate statistics to examine whether financial burden varied by poverty level. Multivariate regression models were used to assess whether family insurance coverage was associated with level of financial burden for low-income families. The main outcome was financial burden, defined as the proportion of family income spent on OOP health care expenditures, including premiums, for all family members. We aggregated annual OOP expenditures for all members of 4,531 families with a child members publicly insured all year, (2) all members privately insured all year, (3) all members uninsured all year, (4) partial coverage, or (5) mix of public and private with no uninsured periods. A regressive gradient was noted for financial burden across income groups, with families with incomes Poverty Level (FPL) spending a mean of 119.66 US dollars OOP per 1,000 US dollars of family income and families with incomes 100-199 percent FPL spending 66.30 US dollars OOP per 1,000 US dollars, compared with 37.75 US dollars for families with incomes >400 percent FPL. For low-income families (families with children. For low-income families, full-year public coverage provides significantly greater protection from financial burden than full-year private coverage.

Income inequality in today’s China

Science.gov (United States)

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

Regional welfare disparities and regional economic growth in Vietnam

NARCIS (Netherlands)

Nguyen Huy Hoang,

2009-01-01

This study had multiple objectives. First, it aimed at examining regional inequality
in several welfare variables, such as health and education during the 1998-2004 period, and
per capita income over time from 1990 to 2006. The first objective of the study was to gain
a better

Racial/ethnic and income disparities in child and adolescent exposure to food and beverage television ads across the U.S. media markets.

Science.gov (United States)

Powell, Lisa M; Wada, Roy; Kumanyika, Shiriki K

2014-09-01

Obesity prevalence and related health burdens are greater among U.S. racial/ethnic minority and low-income populations. Targeted advertising may contribute to disparities. Designated market area (DMA) spot television ratings were used to assess geographic differences in child/adolescent exposure to food-related advertisements based on DMA-level racial/ethnic and income characteristics. Controlling for unobserved DMA-level factors and time trends, child/adolescent exposure to food-related ads, particularly for sugar-sweetened beverages and fast-food restaurants, was significantly higher in areas with higher proportions of black children/adolescents and lower-income households. Geographically targeted TV ads are important to consider when assessing obesity-promoting influences in black and low-income neighborhoods. Copyright © 2014 Elsevier Ltd. All rights reserved.

Socioeconomic Disparities and Health: Impacts and Pathways

Science.gov (United States)

Kondo, Naoki

2012-01-01

Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997–98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society. PMID:22156290

Socioeconomic disparities and health: impacts and pathways.

Science.gov (United States)

Kondo, Naoki

2012-01-01

Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997-98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society.

Inequality in Burkina Faso-to what extent do household, community and regional factors matter?

NARCIS (Netherlands)

J. Gräb (Johannes); M. Grimm (Michael)

2011-01-01

textabstractEmpirical evidence suggests that regional disparities in income are often very wide, that these disparities do not necessarily disappear as economies grow and that these disparities are themselves a major driver of growth. We use a novel approach based on multilevel modelling to

Alternative Estimates of Personal Income Per Capita in Russian Regions

Directory of Open Access Journals (Sweden)

Andrey Viktorovich Yantsen

2017-03-01

Full Text Available Average income per capita is one of the main indicators of the standard of living. This indicator is widely used in research devoted to poverty, interregional income inequality, and is also the main reference point of success of pursued regional policies. A number of researchers note poor quality of official data on household income and call into question their reliability in some regions of Russia. The main reasons include the following: the scale of shadow economy, especially at the level of some regions; insufficient state financing of respective research; and outdated statistical methods of data processing. The author offers the method of quality checking of official statistical data on income per capita by means of a number of indirect indicators. Application of this method also allows receiving alternative estimates of the average per capita income of the population in regions of the country. On the basis of data for 2013-2014 it is shown that in a number of regions official statistical data are underestimated by more than 20%. The received alternative estimates of the average per capita income can be used in further research in place of official indicators

Demographic and economic disparities among Arctic regions

OpenAIRE

Schmidt, Jennifer Irene; Aanesen, Margrethe; Klokov, Konstantin; Kruschov, Sergei; Hausner, Vera Helene

2015-01-01

Accepted manuscript version. Published version at http://doi.org/10.1080/1088937X.2015.1065926. We use demographic and economic indicators to analyze spatial differences and temporal trends across 18 regions surrounding the Arctic Ocean. Multifactor and cluster analysis were used on 10 indicators reflecting income, employment and demography from 1995 to 2008. The main difference is between regions with high population densities, low natural growth rate, and low unemployment (Ru...

Do wealth disparities contribute to health disparities within racial/ethnic groups?

Science.gov (United States)

Pollack, Craig Evan; Cubbin, Catherine; Sania, Ayesha; Hayward, Mark; Vallone, Donna; Flaherty, Brian; Braveman, Paula A

2013-05-01

Though wide disparities in wealth have been documented across racial/ethnic groups, it is largely unknown whether differences in wealth are associated with health disparities within racial/ethnic groups. Data from the Survey of Consumer Finances (2004, ages 25-64) and the Health and Retirement Survey (2004, ages 50+), containing a wide range of assets and debts variables, were used to calculate net worth (a standard measure of wealth). Among non-Hispanic black, Hispanic and non-Hispanic white populations, we tested whether wealth was associated with self-reported poor/fair health status after accounting for income and education. Except among the younger Hispanic population, net worth was significantly associated with poor/fair health status within each racial/ethnic group in both data sets. Adding net worth attenuated the association between education and poor/fair health (in all racial/ethnic groups) and between income and poor/fair health (except among older Hispanics). The results add to the literature indicating the importance of including measures of wealth in health research for what they may reveal about disparities not only between but also within different racial/ethnic groups.

Health Insurance Instability Among Older Immigrants: Region of Origin Disparities in Coverage

Science.gov (United States)

Hardy, Melissa

2015-01-01

Objectives. We provide a detailed analysis of how the dynamics of health insurance coverage (HIC) at older ages differs among Latino, Asian, and European immigrants in the United States. Method. Using Survey of Income and Program Participation data from the 2004 and 2008 panels, we estimate discrete-time event history models to examine first and second transitions into and out of HIC, highlighting substantial differences in hazard rates among immigrants aged 50–64 from Asia, Latin America, and Europe. Results. We find that the likelihood of having HIC at first observation and the rates of gaining and losing coverage within a relatively short time frame are least favorable for older Latino immigrants, although immigrants from all three regions are at a disadvantage relative to native-born non-Hispanic Whites. This disparity among immigrant groups persists even when lower rates of citizenship, greater difficulty with English, and low-skill job placements are taken into account. Discussion. Factors that have contributed to the lower rates and shorter durations of HIC among older immigrants, particularly those from Latin America, may not be easily resolved by the Affordable Care Act. The importance of region of origin and assimilation characteristics for the risk of being uninsured in later life argues that immigration and health care policy should be jointly addressed. PMID:25637934

Sustaining Small Scale Farming: Evidence of Poverty and income Disparity among Rural Farming Households in South-South Region of Nigeria

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Sunday B. Akpan

2016-09-01

Full Text Available The incidence of poverty is evidenced among rural farm households in developing societies. As a result of persistence poverty among rural farm households, there is a sudden upsurge in agricultural livelihood diversification and rural-urban migration resulting in high rate of urban unemployment. To help generate suitable policy variables to help tackle this rampaging issue in the South- south region of Nigeria, this study specifically analyses poverty and income inequality as well as identified determinants of poverty among rural farm households in Akwa Ibom State, Nigeria. Data were collected from 390 rural farm household heads spread across the rural areas of the State. Combination of sampling methods was employed to sample cross-sectional data from respondents. The study used descriptive tools and regression analysis (Tobit regressions to analyse information collected. The socio-economic analysis reveals that most farming household heads were male; an average of 12.3 years of formal was discovered; social capital formation was poor, while average age stood at 42.5 years. About 33.08 % of male headed households and 22.05 % of female-headed households live below poverty line in the study area. Income inequality index revealed 0.4210 for male headed households and 0.4531 for the female counterpart. The Tobit model estimates revealed that, household head farming experience, years in the social organisation, a level of formal education, farm and non-farm income were negative drivers of rural poverty in the region. Household’s age, household size, structure of land ownership and gender were positive drivers of poverty among rural farming households. It is recommended that sound family welfare packages should be implemented in the rural communities. Also, the social capital formation should be promoted among rural farming households, while adult education policies should be re-visited. The government of the region should also improve educational

PENGARUH DESENTRALISASI FISKAL TERHADAP DISPARITAS PENDAPATAN REGIONAL DI INDONESIA TAHUN 2001-200

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Muhammad Andry Nurman

2013-11-01

Full Text Available Studi ini bertujuan untuk menganalisis bagaimanakah pengaruh desentralisasi fiskal terhadap disparitas pendapatan regional di Indonesia selama periode 2001-2008. Studi dilakukan terhadap Kabupaten/Kota di Indonesia yang merupakan titik tolak dari desentralisasi di Indonesia. Sampel yang diteliti sebanyak 253 Kabupaten/Kota. Variabel yang digunakan sebagai proxy dari desentralisasi fiskal adalah: belanja langsung (desentralisasi pengeluaran, serta PAD, DAU dan Dana Bagi Hasil (desentralisasi penerimaan. Studi menggunakan pendekatan data panel dan alat analisis Least Square Dummy Variables (LSDV atau juga dikenal sebagai Fixed Effect Model (FEM dan Newey West Method atau juga dikenal sebagai HAC (heteroscedasticity-and autocorrelation-consistent untuk menghilangkan heteroskedastisitas dan autokorelasi. Hasil studi menunjukkan bahwa variabel belanja langsung telah mampu untuk mengurangi disparitas pendapatan regional, sebaliknya DAU justru mengakibatkan meningkatnya disparitas pendapatan regional. Terdapat indikasi bahwa penyebab utamanya adalah adanya missallocated di dalam mekanisme alokasi DAU. Sementara itu variabel PAD dan Dana Bagi Hasil tidak berpengaruh signifikan terhadap disparitas pendapatan regional. This study aims to analyze how the influence of fiscal decentralization on regional income disparity in Indonesia during the period 2001-2008. Studies conducted on municipalities in Indonesia. 253 municipalities are used as samples. The variables used as proxies of fiscal decentralization are: direct expenditure (expenditure decentralization, and PAD, DAU and DBH (revenue decentralization. The study is using panel data approach and Least Square Dummy Variables (LSDV as an analytical tool or also known as the Fixed Effect Modeland Newey West method or also known as HAC (heteroscedasticity-and Autocorrelation-consistent to remove heteroscedasticity and autocorrelation. The study shows that direct expenditure variable has been able to reduce

Income disparities in healthcare use remain after controlling for healthcare need: evidence from Swedish register data on psoriasis and psoriatic arthritis.

Science.gov (United States)

Löfvendahl, Sofia; Jöud, Anna; Petersson, Ingemar F; Theander, Elke; Svensson, Åke; Carlsson, Katarina Steen

2018-04-01

We used a southern Swedish cohort of psoriasis (PSO) and psoriatic arthritis (PsA) patients and population-based referents (N = 57,800) to investigate the influence of socioeconomic and demographic factors on the probability of healthcare use and on healthcare costs when controlling for need as measured by PSO/PsA and common additional morbidities such as diabetes, depression and myocardial infarction. People with PSO/PsA were identified by ICD-10 codes in the Skåne Healthcare Register 1998-2007. Resource use and costs for years 2008-2011 were retrieved from the Skåne Healthcare Register and the Swedish Prescribed Drug Register, and socioeconomic data were retrieved from Statistics Sweden. After controlling for PSO/PsA and common additional morbidities, income, and to some extent education, had significant effects on the probability of five types of healthcare use. Overall, income showed a bell-shaped relationship to healthcare costs, with patients in income quintiles 2 and 3 having the highest mean annualized cost irrespective of model specification. Education did not have a significant effect in most specifications. Analyses including interaction effects indicated similarly higher costs across income quintiles in the PSO and PsA subgroups, though these cost differences were lower in magnitude for patients with PSO in quintile 5 and with PsA in quintile 1. In conclusion, our results show persistent socioeconomic disparities in healthcare use among a cohort of chronically ill patients and referents, even after controlling for the presence of PSO/PsA and common additional morbidities. These disparities persist even in a country with general healthcare coverage and low out-of-pocket payments.

Assessing needs and assets for building a regional network infrastructure to reduce cancer related health disparities.

Science.gov (United States)

Wells, Kristen J; Lima, Diana S; Meade, Cathy D; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K; Pledger, W Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E; Fouad, Mona; Moreno, Carlos S; Lacey, Michelle; Christie, Debra W; Price-Haywood, Eboni G; Quinn, Gwendolyn P; Coppola, Domenico; Sodeke, Stephen O; Green, B Lee; Lichtveld, Maureen Y

2014-06-01

Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nation-wide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assessing Needs and Assets for Building a Regional Network Infrastructure to Reduce Cancer Related Health Disparities

Science.gov (United States)

Wells, Kristen J.; Lima, Diana S.; Meade, Cathy D.; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K.; Pledger, W. Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E.; Fouad, Mona; Moreno, Carlos S.; Lacey, Michelle; Christie, Debra W.; Price-Haywood, Eboni G.; Quinn, Gwendolyn P.; Coppola, Domenico; Sodeke, Stephen O.; Green, B. Lee; Lichtveld, Maureen Y.

2015-01-01

Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nationwide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals. PMID:24486917

Climate change and drought effects on rural income distribution in the Mediterranean: a case study for Spain

Science.gov (United States)

Quiroga, Sonia; Suárez, Cristina

2016-06-01

This paper examines the effects of climate change and drought on agricultural incomes in Spanish rural areas. Present research has focused on the effects of these extreme climatological events through response functions, considering effects on crop productivity and average incomes. Among the impacts of droughts, we focused on potential effects on income distribution. The study of the effects on abnormally dry periods is therefore needed in order to perform an analysis of diverse social aspects in the long term. We estimate crop production functions for a range of Mediterranean crops in Spain and we use a measure of the decomposition of inequality to estimate the impact of climate change and drought on yield disparities. Certain adaptation measures may require a better understanding of risks by the public to achieve general acceptance. We provide empirical estimations for the marginal effects of the two impacts considered: farms' average income and income distribution. Our estimates consider crop production response to both biophysical and socio-economic aspects to analyse long-term implications on competitiveness and disparities. As for the results, we find disparities in the adaptation priorities depending on the crop and the region analysed.

Regional Disparities in Poverty and Education in India

OpenAIRE

Sivakumar, Marimuthu; Vijay, M

2012-01-01

India is a witness of regional disparities in many sphere of socio- economic development. On one side, world’s majority of new billionaires are in India and on the another side, India has majority of poor people. Like that, in development, the States like Kerala, Tamil Nadu, Punjab, and Gujrat are in the forefront and BIMURAO (Bihar, Madhya Pradesh, Uttar Pradesh, Rajasthan and Orissa) States are far behind in many aspects. The main objective of the Eleventh Plan was faster and inclusive grow...

Regional income inequality model based on theil index decomposition and weighted variance coeficient

Science.gov (United States)

Sitepu, H. R.; Darnius, O.; Tambunan, W. N.

2018-03-01

Regional income inequality is an important issue in the study on economic development of a certain region. Rapid economic development may not in accordance with people’s per capita income. The method of measuring the regional income inequality has been suggested by many experts. This research used Theil index and weighted variance coefficient in order to measure the regional income inequality. Regional income decomposition which becomes the productivity of work force and their participation in regional income inequality, based on Theil index, can be presented in linear relation. When the economic assumption in j sector, sectoral income value, and the rate of work force are used, the work force productivity imbalance can be decomposed to become the component in sectors and in intra-sectors. Next, weighted variation coefficient is defined in the revenue and productivity of the work force. From the quadrate of the weighted variation coefficient result, it was found that decomposition of regional revenue imbalance could be analyzed by finding out how far each component contribute to regional imbalance which, in this research, was analyzed in nine sectors of economic business.

Probabilistic income-maximizing behavior in regional migration: an empirical test.

Science.gov (United States)

Weinstein, R I; Evans, R D

1980-01-01

"This paper provides an empirical test of the hypothesis that migrants consider income risk in their evaluation of the returns to migration in that higher levels of income risk for a given region reduce the rate of net migration into that region." Theoretical approaches to the incorporation of income risk in migration models are first considered, and alternative approaches are then tested using data on white and nonwhite net migration in the United States between 1960 and 1970. The results indicate support for the hypothesis that the extent of net migration is inversely affected by income risk. excerpt

Maternal health service disparities across incomes and implications on prevention of mother-to-child transmission service coverage: current context in Sub-Saharan Africa

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Nibretie Gobezie Workneh

2016-12-01

Full Text Available About 69% of people living with HIV globally and over 90% of the children who acquired HIV infection are in Sub-Saharan Africa. Despite this, promising results have been observed, especially over the last decade – for example, a 25% decline in new HIV infections as compared to 2001 and a 38% decline in the number of children newly infected by HIV in 2012 as compared to 2009. However, the Global Plan and the Global Fast-Track Commitments of eliminating new HIV infections among children require addressing impediments to service expansion. In this regard, this paper attempts to draw attention to the extent to which disparities across income in using antenatal care (ANC services may constrain the prevention of mother-to-child transmission (PMTCT service expansion in Sub-Saharan Africa. The analysis is based on ANC service coverage data from Demographic and Health Surveys conducted between 2008 and 2015 in 31 Sub-Saharan African countries; and PMTCT coverage data from UNAIDS datasets released in 2016. Our analysis found that women in the highest wealth quintile are about three times more likely to frequently use ANC services (at least four visits as compared to those in the lowest wealth quintile (95%CI: 1.7-5.7, P<0.0001. A regression analysis shows that one-quarter of the PMTCT service coverage can be explained by the disparity in ANC use associated with income; and the higher the disparity in ANC use, the lower the PMTCT service (P<0.05. The findings suggest that achieving the ambitious plan of zero new HIV infections among children while keeping their mothers alive will require on-going PMTCT/ANC service integration and ensuring that programs reach women who are most in need; specifically those in the poorest income categories.

Health disparities among the western, central and eastern rural regions of China after a decade of health promotion and disease prevention programming.

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Zhang, Xi-Fan; Tian, Xiang-Yang; Cheng, Yu-Lan; Feng, Zhan-Chun; Wang, Liang; Southerland, Jodi

2015-08-01

Health disparities between the western, central and eastern regions of rural China, and the impact of national health improvement policies and programming were assessed. A total of 400 counties were randomly sampled. ANOVA and Logistic regression modeling were employed to estimate differences in health outcomes and determinants. Significant differences were found between the western, central and eastern rural regions in community infrastructure and health outcomes. From 2000 to 2010, health indicators in rural China were improved significantly, and the infant mortality rate (IMR), maternal mortality rate (MMR) and under 5 mortality rate (U5MR) had fallen by 62.79%, 71.74% and 61.92%, respectively. Central rural China had the greatest decrease in IMR (65.05%); whereas, western rural China had the greatest reduction in MMR (72.99%) but smallest reduction in U5MR (57.36%). Despite these improvements, Logistic regression analysis showed regional differences in key health outcome indicators (odds ratios): IMR (central: 2.13; western: 5.31), U5MR (central: 2.25; western: 5.69), MMR (central: 1.94; western: 3.31), and prevalence of infectious diseases (central: 1.62; western: 3.58). The community infrastructure and health outcomes of the western and central rural regions of China have been improved markedly during the first decade of the 21st century. However, health disparities still exist across the three regions. National efforts to increase per capita income, community empowerment and mobilization, community infrastructure, capacity of rural health facilities, and health literacy would be effective policy options to attain health equity.

Income Tax Revenue as an Indicator of Regional Development in Pakistan

OpenAIRE

Ijaz Hussain; Sumbal Rana

2009-01-01

The objective of this paper is to highlight the use of income tax revenue as an indicator of regional development in Pakistan. Initially, we identify a dramatic shift in income tax revenue trends at the provincial level for the period 1992/93 to 2005/06. We develop a simple model of income tax revenue and estimate the relationship between growth of income tax revenue and gross regional product (GRP). Based on the estimated relationship, Punjab appears to have been the fastest growing province...

Rising inequalities in income and health in China: Who is left behind?

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Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

2013-01-01

In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991–2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to health disparities between rich and poor. We find that health disparities in China relate to rising income inequality and in particular to the adverse health and income experience of older (wo)men, but not to the growth rate of average incomes over the last decades. These findings suggest that replacement incomes and pensions at older ages may be one of the most important policy levers for reducing health disparities between rich and poor Chinese. PMID:24189450

Breast cancer screening disparities among immigrant women by world region of origin: a population-based study in Ontario, Canada.

Science.gov (United States)

Vahabi, Mandana; Lofters, Aisha; Kumar, Matthew; Glazier, Richard H

2016-07-01

Rates of mammography screening for breast cancer are disproportionately low in certain subgroups including low-income and immigrant women. The purpose of the study was to examine differences in rates of appropriate breast cancer screening (i.e., screening mammography every 2 years) among Ontario immigrant women by world region of origin and explore the association between appropriate breast cancer screening among these women groups and individual and structural factors. A cohort of 183,332 screening-eligible immigrant women living in Ontario between 2010 and 2012 was created from linked databases and classified into eight world regions of origin. Appropriate screening rates were calculated for each region by age group and selected sociodemographic, immigration, and healthcare-related characteristics. The association between appropriate screening across the eight regions of origin and selected sociodemographic, immigration, and health-related characteristics was explored using multivariate Poisson regression. Screening varied by region of origin, with South Asian women (48.5%) having the lowest and Caribbean and Latin American women (63.7%) the highest cancer screening rates. Factors significantly associated with lower screening across the world regions of origin included living in the lowest income neighborhoods, having a refugee status, being a new immigrant, not having a regular physical examination, not being enrolled in a primary care patient enrollment model, having a male physician, and having an internationally trained physician. Multiple interventions entailing cross-sector collaboration, promotion of patient enrollment models, community engagement, comprehensive and intensive outreach to women, and knowledge translation and transfer to physicians should be considered to address screening disparities among immigrant population. Consideration should be given to design and delivery of culturally appropriate and easily accessible cancer screening programs

Gender and regional disparities of tuberculosis in Hunan, China

OpenAIRE

Chen, Mengshi; Kwaku, Abuaku Benjamin; Chen, Youfang; Huang, Xin; Tan, Hongzhuan; Wen, Shi Wu

2014-01-01

Introduction Major efforts have been made to improve the health care system in Hunan province, China. The aims of this study were to assess whether and to what extent these efforts have impacted on gender and regional disparities of Tuberculosis (TB) incidence in recent years, especially for less developed areas. Methods We obtained data from the 2005–2009 China Information System for Disease Control and Prevention (CISDCP)to conduct this study in Hunan province. Counties within the province ...

Widening Geographical Disparities in Cardiovascular Disease Mortality in the United States, 1969-2011

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Gopal K. Singh, PhD

2015-04-01

Full Text Available Objectives: This study examined trends in geographical disparities in cardiovascular-disease (CVD mortality in the United States between 1969 and 2011. Methods: National vital statistics data and the National Longitudinal Mortality Study were used to estimate regional, state, and county-level disparities in CVD mortality over time. Log-linear, weighted least squares, and Cox regression were used to analyze mortality trends and differentials. Results: During 1969-2011, CVD mortality rates declined fastest in New England and Mid-Atlantic regions and slowest in the Southeast and Southwestern regions. In 1969, the mortality rate was 9% higher in the Southeast than in New England, but the differential increased to 48% in 2011. In 2011, Southeastern states, Mississippi and Alabama, had the highest CVD mortality rates, nearly twice the rates for Minnesota and Hawaii. Controlling for individual-level covariates reduced state differentials. State- and county-level differentials in CVD mortality rates widened over time as geographical disparity in CVD mortality increased by 50% between 1969 and 2011. Area deprivation, smoking, obesity, physical inactivity, diabetes prevalence, urbanization, lack of health insurance, and lower access to primary medical care were all significant predictors of county-level CVD mortality rates and accounted for 52.7% of the county variance. Conclusions and Global Health Implications: Although CVD mortality has declined for all geographical areas in the United States, geographical disparity has widened over time as certain regions and states, particularly those in the South, have lagged behind in mortality reduction. Geographical disparities in CVD mortality reflect inequalities in socioeconomic conditions and behavioral risk factors. With the global CVD burden on the rise, monitoring geographical disparities, particularly in low- and middle-income countries, could indicate the extent to which reductions in CVD mortality are

Rising inequalities in income and health in China: who is left behind?

Science.gov (United States)

Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

2013-12-01

In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991-2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to health disparities between rich and poor. We find that health disparities in China relate to rising income inequality and in particular to the adverse health and income experience of older (wo)men, but not to the growth rate of average incomes over the last decades. These findings suggest that replacement incomes and pensions at older ages may be one of the most important policy levers for reducing health disparities between rich and poor Chinese. Copyright © 2013 Elsevier B.V. All rights reserved.

China's regional disparities in energy consumption: An input–output analysis

International Nuclear Information System (INIS)

Li, Zheng; Pan, Lingying; Fu, Feng; Liu, Pei; Ma, Linwei; Amorelli, Angelo

2014-01-01

While most of previous studies on China's energy conservation took the huge country as a whole, this manuscript revealed the obvious regional disparities in energy consumption of China's 30 provinces. Based on a hybrid energy input–output model, the total energy consumption of different regions was decomposed and compared using three measurements of embodied energy in inter-regional trade: 1) only considered inter-regional energy trade; 2) considered embodied energy in flow-out of final goods and services; 3) considered embodied energy in flow-in of final goods and services. Based on the second and third measurements, the 30 regions were categorized into four groups by their energy intensity and per capita GDP (gross domestic production). Common characteristics of decomposed regional energy intensity are discussed, and policy implication for regional energy conservation is provided. For developed regions with low energy intensities, such as Shanghai, energy conservation should focus on promoting low energy-consuming life style. For under-developed regions with low energy intensities, such as Guangxi, economic development is more urgent than energy conservation. For developing and energy absorbing regions, improving energy efficiency in industries is significant. For developing and energy exporting regions, transforming primary energy into high value-added products would be beneficial for economic development and energy conservation. - Highlights: • A hybrid input–output model for the decomposition of regional energy consumption. • A discussion of China's regional disparities in energy consumption by model results. • Regional energy consumption was compared by three measurements of embodied energy. • 30 regions of China were categorized into four groups by energy intensity and GDP

Lambayeque Region marketing: Improving Incoming Tourism

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Roger Pingo Jara

2012-12-01

Full Text Available Up to now, the marketing of the Lambayeque region as a tourist destination has been able to make important progress in the growth of domestic tourists flow. 40% of these tourists come from the capital, mostly they arrive in this region, mainly for business reasons. However, little progress is shown in relation to Incoming tourism, because from 100% of visitors who arrive to this touristic destination only 5% are of foreign origin.Furthermore, in 2011, from the total foreign tourists that visited the Moche Route - La Libertad region and Lambayeque region, 70% remained in the first one and only 30% visited both regions, completing the touristic circuit. The recommendations of the teachers of the Universidad del Pacífico, Universidad Esan and Centrum Católica, who have been interviewed are compared with the businessmen’s opinions in the region, showing the importance of targeting the tourism marketing strategy. Thus, it seeks to create value in different niches of the source markets, to prioritize potential tourists from brotherly countries, to link emotionally the tourist with the city, to build brands for each touristic product, to invest in highly specialized tourism and to improve significantly the clusters organization of the tourism sector in the region.We conclude that, in the region of Lambayeque, isolated efforts have been made regarding the incoming marketing, but, according to the needs, tastes and preferences of the potential tourist, this does not fulfill the international standards. This is demonstrated by the results achieved up to now—in terms of the foreign visitors’ number—. To that extent, It emphasizes the importance of the design and the implementation of a marketing plan connected with market reality.It should profit from the national brand and develop regional and local brand based on the international touristic demand-supply relation to market niches.

Income inequality, decentralisation, and regional development in Western Europe

NARCIS (Netherlands)

Tselios, Vassilis; Rodriguez-Pose, Andres; Pike, Andy; Tomaney, John; Torrisi, Gianpiero

This paper deals with the relationship between decentralisation, regional economic development, and income inequality within regions. Using multiplicative interaction models and regionally aggregated microeconomic data for more than 100000 individuals in the European Union (EU), it addresses two

The Analysis of Regional Disparities in Romania with Gini/Struck Coefficients of Concentration

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DANIELA ANTONESCU

2010-12-01

Full Text Available A key objective of regional development policy is to reduce disparities between regions and to ensure a relatively balanced level of development. To achieve this goal studies and social and economic analysis based on certain techniques and methods of evaluation are necessary. In scientific literature, there are plenty of models that can be applied to assess regional disparities. One of the methods commonly used in practice is related to the calculation and analysis of the degree of concentration/diversification of activities within a region. The increase or decrease in the degree of concentration of certain activities or areas of activity in a region provides information on: - the level of overall economic development; - economic development and growth rate; - the specific features of the region, the potential, local traditions, etc. The expert analysis indicate that, in a high level of overall development or a sustained economic growth rate, there are favorable conditions for economic activities to locate in any region, so they are relatively uniformly distributed throughout the country.Knowing the degree of concentration and also the influence factors are useful in making decisions and setting regional policy measures.This article proposes a synthetic analysis of the development level of regions in Romania with the concentration/diversification model (Gini/Struck coefficients, based on the existing key statistical indicators.

Dynamic Development of Regional Disparity in Mainland China: An Experimental Study Based on a Multidimensional Index

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Peng Bin

2016-12-01

Full Text Available This paper stems from the previous wisdom to investigate the transitional dynamics of regional disparity in China during the period 1998–2010. This is the very first time that 30 Chinese regions have been benchmarked according to a multidimensional index based on a stochastic kernel density. The multidimensional index contains five domains to capture the socioeconomic development: macroeconomic conditions, science and innovation, environmental sustainability, human capital, and public facilities. This experimental study reveals the existence of a three-peak pattern of convergence during 1998–2010, and improves the understanding of the evolution of regional disparity in China in terms of the comprehensive socioeconomic development.

Income inequality and socioeconomic gradients in mortality.

Science.gov (United States)

Wilkinson, Richard G; Pickett, Kate E

2008-04-01

We investigated whether the processes underlying the association between income inequality and population health are related to those responsible for the socioeconomic gradient in health and whether health disparities are smaller when income differences are narrower. We used multilevel models in a regression analysis of 10 age- and cause-specific US county mortality rates on county median household incomes and on state income inequality. We assessed whether mortality rates more closely related to county income were also more closely related to state income inequality. We also compared mortality gradients in more- and less-equal states. Mortality rates more strongly associated with county income were more strongly associated with state income inequality: across all mortality rates, r= -0.81; P=.004. The effect of state income inequality on the socioeconomic gradient in health varied by cause of death, but greater equality usually benefited both wealthier and poorer counties. Although mortality rates with steep socioeconomic gradients were more sensitive to income distribution than were rates with flatter gradients, narrower income differences benefit people in both wealthy and poor areas and may, paradoxically, do little to reduce health disparities.

Impact of Polycentric Urban Systems on Intra-regional Disparities: A Microregional Approach

Czech Academy of Sciences Publication Activity Database

Malý, Jiří

2016-01-01

Roč. 24, č. 1 (2016), s. 116-138 ISSN 0965-4313 Institutional support: RVO:68145535 Keywords : spatial development * polycentricity * intra-regional disparities * Czech Republic Subject RIV: DE - Earth Magnetism, Geodesy, Geography Impact factor: 1.332, year: 2016 http://dx.doi.org/10.1080/09654313.2015.1054792

Gender Disparity in Education Enrollment in Pakistan

OpenAIRE

Shakil Quayes; Richard David Ramsey

2015-01-01

The paper examines the determinants of school enrollment in Pakistan. The likelihood of school enrollment is estimated using separate logistic regression models for three different age groups. The empirical results indicate severe gender disparity in school enrollment across all age groups, particularly among the older age groups. Although the rate of school enrollment is positively associated with household income, the gender disparity actually deteriorates with an increase in household inco...

Secular changes in mortality disparities in New York City: a reexamination.

Science.gov (United States)

Althoff, Keri N; Karpati, Adam; Hero, Joachim; Matte, Thomas D

2009-09-01

Previously published analyses showed that inequalities in mortality rates between residents of poor and wealthy neighborhoods in New York City (NYC) narrowed between 1990 and 2000, but these trends may have been influenced by population in-migration and gentrification. The NYC public housing population has been less subject to these population shifts than those in other NYC neighborhoods. We compared changes in mortality rates (MRs) from 1989-1991 to 1999-2001 among residents of NYC census blocks consisting entirely of public housing residences with residents of nonpublic housing low-income and higher-income blocks. Public housing and nonpublic housing low-income blocks were those in census block groups with > or =50% of residents living at <1.5 times the federal poverty level (FPL); nonpublic housing higher-income blocks were those in census block groups with <50% of residents living at <1.5 times the FPL. Information on deaths was obtained from NYC's vital registry, and US Census data were used for denominators. Age-standardized all-cause MRs in public housing, low-income, and higher-income residents decreased between the decades by 16%, 28%, and 22%, respectively. While mortality rate ratios between low-income and higher-income residents narrowed by 8%, the relative disparity between public housing and low-income residents widened by 21%. Diseases amenable to prevention including malignancies, diabetes, and chronic lung disease contributed to the increased overall mortality disparity between public housing and lower-income residents. These findings temper previous findings that inequalities in the health of poor and wealthier NYC neighborhood residents have narrowed. NYC public housing residents should be a high-priority population for efforts to reduce health disparities.

Growing Income Inequality Threatens American Education

Science.gov (United States)

Duncan, Greg J.; Murnane, Richard J.

2014-01-01

The first of two articles in consecutive months describes the origins and nature of growing income inequality, and some of its consequences for American children. It documents the increased family income inequality that's occurred over the past 40 years and shows that the increased income disparity has been more than matched by an expanding…

Eye disease, the fertility decline, and the emergence of global income differences

DEFF Research Database (Denmark)

Andersen, Thomas B.; Dalgaard, Carl-Johan Lars; Selaya, Pablo

2014-01-01

This research advances and empirically establishes the hypothesis that regional variation in the historical incidence of eye disease has influenced the current global distribution of per capita income. By reducing work life expectancy, high historical eye disease incidence has served to diminish...... the incentive to accumulate skills, thereby delaying the fertility transition and the take-off to sustained economic growth. As a consequence of a differential timing of the take-off to growth, prompted by differences in the inherent return to skill formation, global income disparities have emerged....

Disparities in sexually transmitted disease rates across the "eight Americas".

Science.gov (United States)

Chesson, Harrell W; Kent, Charlotte K; Owusu-Edusei, Kwame; Leichliter, Jami S; Aral, Sevgi O

2012-06-01

The purpose of this study was to examine rates of 3 bacterial sexually transmitted diseases (STDs; syphilis, gonorrhea, and chlamydia) in 8 subpopulations (known as the "eight Americas") defined by race and a small number of county-level sociodemographic and geographical characteristics. The eight Americas are (1) Asians and Pacific Islanders in specific counties; (2) Northland low-income rural white; (3) Middle America; (4) Low-income whites in Appalachia and Mississippi Valley; (5) Western Native American; (6) Black middle America; (7) Southern low-income rural black; and (8) High-risk urban black. A list of the counties comprising each of the eight Americas was obtained from the corresponding author of the original eight Americas project, which examined disparities in mortality rates across the eight Americas. Using county-level STD surveillance data, we calculated syphilis, gonorrhea, and chlamydia rates (new cases per 100,000) for each of the eight Americas. Reported STD rates varied substantially across the eight Americas. STD rates were generally lowest in Americas 1 and 2 and highest in Americas 6, 7, and 8. Although disparities in STDs across the eight Americas are generally similar to the well-established disparities in STDs across race/ethnicity, the grouping of counties into the eight Americas does offer additional insight into disparities in STDs in the United States. The high STD rates we found for black Middle America are consistent with the assertion that sexual networks and social factors are important drivers of racial disparities in STDs.

Regional Disparities and Territorial Indicators in Turkey: Socio-Economic Development Index (SEDI)

OpenAIRE

Metin Ozaslan; Bulent Dincer; Huseyin Ozgur

2006-01-01

This aim of this article is to examine the problem of regional disparities in Turkey applying to the economic and social development indicators. One of the main problems encountered in the field of regional development in Turkey is the difficulties in having access to qualified data as is the case in other countries. Therefore, it is of great importance to improve the information gathering and evaluation systems in Turkey. Social and economic development index (SEDI) rankings have contributed...

Deepening Disparity: Income Equality in New York City.

Science.gov (United States)

Elliott, Mark; Grote, Mae Watson; Levin-Waldman, Oren M.

Analysis of the Current Population Survey data for New York City reveals that the economic growth of the 1990s increased the income of families across the earnings spectrum nationally; however, earnings among families in the top quintile outpaced other quintiles, leading to an increase in income inequality. This inequality was substantially…

The Impact of Output Dynamics on Income Inequality in the Russian Regions

Directory of Open Access Journals (Sweden)

Natalia Vasilievna Vashchelyuk

2015-12-01

Full Text Available According to the well-known theoretical approach (the Kuznets hypothesis, one should expect a rise in income inequality on the early stages of economic development followed by its decline on the later phases. But there are theoretical models, which suggest alternative paths of income disparity. Empirical evidences of different authors is also controversial. This paper analyses the relationship between income inequality and output in Russian regions. Such study, based on modern econometric techniques, is novel for Russia. The author uses different economic indicators for Russian regions and estimates the fixed effects model for the period from 2000 to 2011. The results indicate that there is a positive relationship between income inequality measured by Gini coefficient and real per capita gross regional product. Hence, the distribution of benefits of economic growth and losses due to economic contraction was unequal in this period. The decline of inequality was attributable to interregional migration processes, the rise in social expenditure and the ratio of employees with a higher level of education to the employees with a lower level of education. However, the increase in the share of firms implemented technological, management and marketing innovations caused the upswing in income disparity due to monopolistic effects. Thus, the statement of J. F. Kennedy that “a rising tide shifts all boats” is not suitable for the developments in Russian regions in 2000–2011.

Disparities in Survival with Bystander CPR following Cardiopulmonary Arrest Based on Neighborhood Characteristics

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Nina Thakkar Rivera

2016-01-01

Full Text Available The American Heart Association reports the annual incidence of out-of-hospital cardiopulmonary arrests (OHCA is greater than 300,000 with a survival rate of 9.5%. Bystander cardiopulmonary resuscitation (CPR saves one life for every 30, with a 10% decrease in survival associated with every minute of delay in CPR initiation. Bystander CPR and training vary widely by region. We conducted a retrospective study of 320 persons who suffered OHCA in South Florida over 25 months. Increased survival, overall and with bystander CPR, was seen with increasing income (p=0.05, with a stronger disparity between low- and high-income neighborhoods (p=0.01 and p=0.03, resp.. Survival with bystander CPR was statistically greater in white- versus black-predominant neighborhoods (p=0.04. Increased survival, overall and with bystander CPR, was seen with high- versus low-education neighborhoods (p=0.03. Neighborhoods with more high school age persons displayed the lowest survival. We discovered a significant disparity in OHCA survival within neighborhoods of low-income, black-predominance, and low-education. Reduced survival was seen in neighborhoods with larger populations of high school students. This group is a potential target for training, and instruction can conceivably change survival outcomes in these neighborhoods, closing the gap, thus improving survival for all.

AGRICULTURE AND THE SOCIALECONOMIC SITUATION OF THE RURAL POPULATION IN GEORGIA: A CASE STUDY FOCUSING ON THE KAKHETI-REGION

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Boris FORKEL

2009-08-01

Full Text Available Like in many other transition countries, agriculture in Georgia is usually termed as subsistence farming. Lack of employment opportunities and insufficient household income make rural people dependent on state-funded pensionschemes and agricultural production. Similarly, the income-disparity between rural households is also noticed remarkably, while citizens of smaller towns possess, on average, higher income. The study presented in this report is intended to explore the situation of rural households concerning parcel size, employment opportunities, income sources and income disparities between citizens of villages and small towns, by presenting findings obtained during a field survey conducted during the months of March and May 2008 in the Kakheti region in eastern Georgia.

Ideal Body Size as a Mediator for the Gender-Specific Association Between Socioeconomic Status and Body Mass Index: Evidence From an Upper-Middle-Income Country in the African Region.

OpenAIRE

Yepes Maryam; Maurer Jürgen; Stringhini Silvia; Viswanathan Barathi; Gedeon Jude; Bovet Pascal

2016-01-01

While obesity continues to rise globally the associations between body size gender and socioeconomic status (SES) seem to vary in different populations and little is known on the contribution of perceived ideal body size in the social disparity of obesity in African countries. We examined the gender and socioeconomic patterns of body mass index (BMI) and perceived ideal body size in the Seychelles a middle income small island state in the African region. We also assessed the potential role of...

Examining the interlinkages between regional infrastructure disparities, economic growth, and poverty: A case of Indian states

Directory of Open Access Journals (Sweden)

Chotia Varun

2015-01-01

Full Text Available This paper investigates the interlinkages between regional infrastructure disparities, economic growth, and poverty in the 21 major Indian States. An overall comprehensive index of infrastructure, the Composite Infrastructure Index (CII, is calculated for each Indian state using the Principal Component Analysis technique. In order to analyse the regional disparities between states in terms of infrastructure, they are ranked based on the calculated CII. We extend our analysis by evaluating the inter-relationship between the Composite Infrastructure Index, Per Capita Net State Domestic Product (PCNSDP, and poverty. The empirical analysis also proves that composite infrastructural growth and economic growth go hand in hand.

Realized Incomes And Revenues Of Local And Branch (Regional Self-Government Units With Audit Review On Income-Earning Property

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Dubravka Mahaček

2009-07-01

Full Text Available In addition to other incomes, the incomes of local and branch (regional self-government units are made by the income-earning property as well. Statutory provisions determine their realization. This work presents basic kinds of these incomes with legal foundation, which is the base for their realization. The realization was observed on the county-level for a definite period (from 2003 to 2005. It is important to emphasise that the county-level realization includes the realization of the stated incomes within the frame of cities and communes on their area.

Pengaruh Pertumbuhan Ekonomi Dan Disparitas Pendapatan Antardaerah Terhadap Kesejahteraan Masyarakat Provinsi Bali

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I Komang Oka Artana Yasa

2015-11-01

Full Text Available Public welfare is goal of development. Its can be seen from increasing economic growth and inequality in income distribution. Although welfare of Bali is increasing every year, but increase is still relatively low and still occurregionalincome disparities. This study aims to determine regional income disparitiesof Bali and the relationship between economic growth, regional income disparities ofpublic welfare. This study uses secondary data was analyzed using analysis of Index Williamson and path analysis. The analysis shows income disparity between regions of Bali Province in 2001-2012 decreased by an average value of 0.29 means that relatively low levels of disparity. Economic growth in a negative and significant impact on regional income disparities, but a positive and significant impact on public welfare. Regional income disparities in a negative and significant impact on public welfare. Economic growth was indirect effect on public welfare through regional income disparities. Local governments in development policy to pay attention to economic growth and income distribution in order to create a public welfare.

Influence of capital expenditure and income original region to the income per capita in Indonesia

Science.gov (United States)

Muda, Iskandar; Annisa Fitri Hutapea, Azura

2018-03-01

This study aims to determine the Capital Expenditure and Income Original Region is considered to have a significantly positive effect on the increase in income per capita in the Government of North Sumatera Province and West Java Province. The method of research in this thesis is by using a causal research design, with a sample of 25 districts/cities in North Sumatera Province and West Java Province. This study was conducted for the period 2012-2015. The type of data used is secondary data. The method of analysis used in this research is SEM method using software AMOS. The result of this hypothesis shows that simultaneously both independent variables significantly influence to increase of income per capita.

State of equity: childhood immunization in the World Health Organization African Region.

Science.gov (United States)

Casey, Rebecca Mary; Hampton, Lee McCalla; Anya, Blanche-Philomene Melanga; Gacic-Dobo, Marta; Diallo, Mamadou Saliou; Wallace, Aaron Stuart

2017-01-01

In 2010, the Global Vaccine Action Plan called on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) by 2015 and for all vaccines in national immunization schedules by 2020. The aims of this study are to analyze recent trends in national vaccination coverage in the World Health Organization African Region andto assess how these trends differ by country income category. We compared national vaccination coverage estimates for DTP3 and the first dose of measles-containing vaccine (MCV) obtained from the World Health Organization (WHO)/United Nations Children's Fund (UNICEF) joint estimates of national immunization coverage for all African Region countries. Using United Nations (UN) population estimates of surviving infants and country income category for the corresponding year, we calculated population-weighted average vaccination coverage by country income category (i.e., low, lower middle, and upper middle-income) for the years 2000, 2005, 2010 and 2015. DTP3 coverage in the African Region increased from 52% in 2000 to 76% in 2015,and MCV1 coverage increased from 53% to 74% during the same period, but with considerable differences among countries. Thirty-six African Region countries were low income in 2000 with an average DTP3 coverage of 50% while 26 were low income in 2015 with an average coverage of 80%. Five countries were lower middle-income in 2000 with an average DTP3 coverage of 84% while 12 were lower middle-income in 2015 with an average coverage of 69%. Five countries were upper middle-income in 2000 with an average DTP3 coverage of 73% and eight were upper middle-income in 2015 with an average coverage of 76%. Disparities in vaccination coverage by country persist in the African Region, with countries that were lower middle-income having the lowest coverage on average in 2015. Monitoring and addressing these disparities is essential for meeting

Mapping the Energy Flow from Supply to End Use in three Geographic Regions of China

DEFF Research Database (Denmark)

Mischke, Peggy; Xiong, Weiming

China's past economic development policies resulted in different energy infrastructure patterns across China. There is a long tradition in analysing and discussing regional disparities of China's economy. For more than 20 years, regional differences in GDP, industrial outputs, household income...... and consumption were analysed across China's provincial units. Regional disparities in China's current energy flow are rarely visualised and quantified from a comprehensive, system-wide perspective that is tracing all major fuels and energy carriers in supply, transformation and final end-use in different sectors....... A few national and provincial energy flow diagrams of China were developed since 2000, althoug with limited detail on major regional disparities and inter-regional fuel flows. No regional energy flow charts are yet available for East-, Central- and West-China. This study maps and quantifies energy...

The Impact of Output Dynamics on Income Inequality in the Russian Regions

OpenAIRE

Natalia Vasilievna Vashchelyuk

2015-01-01

According to the well-known theoretical approach (the Kuznets hypothesis), one should expect a rise in income inequality on the early stages of economic development followed by its decline on the later phases. But there are theoretical models, which suggest alternative paths of income disparity. Empirical evidences of different authors is also controversial. This paper analyses the relationship between income inequality and output in Russian regions. Such study, based on modern ec...

Regional Convergence of Income: Spatial Analysis

Directory of Open Access Journals (Sweden)

Vera Ivanovna Ivanova

2014-12-01

Full Text Available Russia has a huge territory and a strong interregional heterogeneity, so we can assume that geographical factors have a significant impact on the pace of economic growth in Russian regions. Therefore the article is focused on the following issues: 1 correlation between comparative advantages of geographical location and differences in growth rates; 2 impact of more developed regions on their neighbors and 3 correlation between economic growth of regions and their spatial interaction. The article is devoted to the empirical analysis of regional per capita incomes from 1996 to 2012 and explores the dynamics of the spatial autocorrelation of regional development indicator. It is shown that there is a problem of measuring the intensity of spatial dependence: factor value of Moran’s index varies greatly depending on the choice of the matrix of distances. In addition, with the help of spatial econometrics the author tests the following hypotheses: 1 there is convergence between regions for a specified period; 2 the process of beta convergence is explained by the spatial arrangement of regions and 3 there is positive impact of market size on regional growth. The author empirically confirmed all three hypotheses

Energy price disparity and public welfare

International Nuclear Information System (INIS)

Templet, P.H.

2001-01-01

The differences in the price of energy to economic sectors are linked to a number of system parameters and to public welfare. There are large disparities in energy prices within states when comparing residential and industrial prices although neoclassical economics predicts one price in markets. The large disparities between the two sectors across states negatively affects the efficiency of resource allocation, creates subsidies for those getting the cheap energy and results in unequal access to energy. These in turn lead to inefficient partitioning of energy between products and waste, higher pollution, leakage of wealth and poorer energy use efficiency, i.e. high energy intensity. States with large energy price disparities between sectors have statistically higher poverty, lower incomes, more pollution and use more energy but with less efficiency. Higher energy price disparities also result in higher throughput per unit of output thus reducing the chances for sustainability and lower public welfare. 31 refs

Widening socio-economic disparities in early childhood obesity in Los Angeles County after the Great Recession.

Science.gov (United States)

Nobari, Tabashir Z; Whaley, Shannon E; Crespi, Catherine M; Prelip, Michael L; Wang, May C

2018-04-02

While economic crises can increase socio-economic disparities in health, little is known about the impact of the 2008-09 Great Recession on obesity prevalence among children, especially low-income children. The present study examined whether socio-economic disparities in obesity among children of pre-school age participating in a federal nutrition assistance programme have changed since the recession. A pre-post observational study using administrative data of pre-school-aged programme participants from 2003 to 2014. Logistic regression was used to examine whether the relationship between obesity prevalence (BMI≥95th percentile of the Centers for Disease Control and Prevention's growth charts) and three measures of socio-economic status (household income, household educational attainment, neighbourhood-level median household income) changed after the recession by examining the interaction between each socio-economic status measure and a 5-year time-period variable (2003-07 v. 2010-14), stratified by child's age and adjusted for child's sociodemographic characteristics. Los Angeles County, California, USA. Children aged 2-4 years (n 1 637 788) participating in the Special Supplemental Nutrition Program for Women, Infants, and Children. The magnitude of the association of household income and household education with obesity increased after 2008-09 among 3- and 4-year-olds and 2- and 3-year-olds, respectively. However, the magnitude of the association of neighbourhood-level median household income with obesity did not change after 2008-09. Disparities in obesity by household-level socio-economic status widened after the recession, while disparities by neighbourhood-level socio-economic status remained the same. The widening household-level socio-economic disparities suggest that obesity prevention efforts should target the most vulnerable low-income children.

Disparities in children’s vocabulary and height in relation to household wealth and parental schooling: A longitudinal study in four low- and middle-income countries

Directory of Open Access Journals (Sweden)

Sarah A. Reynolds

2017-12-01

Full Text Available Children from low socio-economic status (SES households often demonstrate worse growth and developmental outcomes than wealthier children, in part because poor children face a broader range of risk factors. It is difficult to characterize the trajectories of SES disparities in low- and middle-income countries because longitudinal data are infrequently available. We analyze measures of children’s linear growth (height at ages 1, 5, 8 and 12y and receptive language (Peabody Picture Vocabulary Test at ages 5, 8 and 12y in Ethiopia, India, Peru and Vietnam in relation to household SES, measured by parental schooling or household assets. We calculate children’s percentile ranks within the distributions of height-for-age z-scores and of age- and language-standardized receptive vocabulary scores. We find that children in the top quartile of household SES are taller and have better language performance than children in the bottom quartile; differences in vocabulary scores between children with high and low SES are larger than differences in the height measure. For height, disparities in SES are present by age 1y and persist as children age. For vocabulary, SES disparities also emerge early in life, but patterns are not consistent across age; for example, SES disparities are constant over time in India, widen between 5 and 12y in Ethiopia, and narrow in this age range in Vietnam and Peru. Household characteristics (such as mother’s height, age, and ethnicity, and community fixed effects explain most of the disparities in height and around half of the disparities in vocabulary. We also find evidence that SES disparities in height and language development may not be fixed over time, suggesting opportunities for policy and programs to address these gaps early in life.

Determinants of social quality and their regional disparities: an integrated approach for health equity in South Korea.

Science.gov (United States)

Jung, Minsoo

2014-01-01

Quality of life was originally included in the concept of social quality (SQ), which refers to the possibility of manifesting the life chance possessed by each individual and the consequences resulting from restricting such possibility. Social quality describes how favorable the socioenvironmental components are that impact the possibility of an individual's life. Despite the close relationship between community capacity and SQ, the components and regional disparities of SQ have not yet been examined. This study identified community-based distribution and disparities of SQ in South Korea, including health indicators. Standardized methods of SQ were used to examine the interrelationships among institutional capacity, citizen capacity, and their associations with population-based health indicators. Under the principles of conceptual suitability, reliability, clarity, comparability, and changeability, a total of 18 SQ indicators were collected, then transformed by European Social Survey standardization and Geographical Information System computation. In the results, the hidden structure that determined the distribution of the SQ indicators was the financial independence and average length of residence. Financial independence indicated the size of the budget that each local community controls was out of the total budget. The average length of residence showed a reverse-U-shape relation to the mutual supports of the residents. The regional distribution of the SQ indicators largely differed from the local economic index or health indicators. Disparities in SQ indicators are likely to arise from the degree of urbanization and the degree of citizens' cohesiveness. Therefore, it is necessary to analyze in-depth cases of both local government with high SQ indicators in all fields and those with low SQ indicators in all fields. In addition, there is a need to elucidate the structural causes and backgrounds that produce disparities in SQ, thus lowering disparities among

National and regional under-5 mortality rate by economic status for low-income and middle-income countries: a systematic assessment.

Science.gov (United States)

Chao, Fengqing; You, Danzhen; Pedersen, Jon; Hug, Lucia; Alkema, Leontine

2018-05-01

The progress to achieve the fourth Millennium Development Goal in reducing mortality rate in children younger than 5 years since 1990 has been remarkable. However, work remains to be done in the Sustainable Development Goal era. Estimates of under-5 mortality rates at the national level can hide disparities within countries. We assessed disparities in under-5 mortality rates by household economic status in low-income and middle-income countries (LMICs). We estimated country-year-specific under-5 mortality rates by wealth quintile on the basis of household wealth indices for 137 LMICs from 1990 to 2016, using a Bayesian statistical model. We estimated the association between quintile-specific and national-level under-5 mortality rates. We assessed the levels and trends of absolute and relative disparity in under-5 mortality rate between the poorest and richest quintiles, and among all quintiles. In 2016, for all LMICs (excluding China), the aggregated under-5 mortality rate was 64·6 (90% uncertainty interval [UI] 61·1-70·1) deaths per 1000 livebirths in the poorest households (first quintile), 31·3 (29·5-34·2) deaths per 1000 livebirths in the richest households (fifth quintile), and in between those outcomes for the middle quintiles. Between 1990 and 2016, the largest absolute decline in under-5 mortality rate occurred in the two poorest quintiles: 77·6 (90% UI 71·2-82·6) deaths per 1000 livebirths in the poorest quintile and 77·9 (72·0-82·2) deaths per 1000 livebirths in the second poorest quintile. The difference in under-5 mortality rate between the poorest and richest quintiles decreased significantly by 38·8 (90% UI 32·9-43·8) deaths per 1000 livebirths between 1990 and 2016. The poorest to richest under-5 mortality rate ratio, however, remained similar (2·03 [90% UI 1·94-2·11] in 1990, 1·99 [1·91-2·08] in 2000, and 2·06 [1·92-2·20] in 2016). During 1990-2016, around half of the total under-5 deaths occurred in the poorest two quintiles

Regional disparities and carbon “outsourcing”: The political economy of China's energy policy

International Nuclear Information System (INIS)

Li, Huimin; Wu, Tong; Zhao, Xiaofan; Wang, Xiao; Qi, Ye

2014-01-01

Since 2007, gross domestic product (GDP) growth in China's inland provinces has exceeded that of the affluent coastal provinces. Concurrently, they have also been given more lenient energy intensity reduction targets to provide latitude for continued growth. The regional unevenness of economic development and energy policy has implications for the ability of the country to achieve its energy savings target – an objective that has become the key part of China's climate change mitigation strategy. This study shows that there is an explicit trend in which changes in regional economic structure is moving towards increasing national energy intensity. This is due, in large part, to carbon leakage between provinces. Changes in regional economic structure increased national energy intensity by 0.13% during the 11th five-year plans (FYP) period, and is on track to cause a further increase of 1.35% during the 12th FYP period. In formulating national energy policy, the existing “Target Responsibility System” (TRS) of policy implementation may need to be improved. Regional economic disparities must be taken directly into account in policymaking, as inland provinces should be assigned higher, not lower, energy intensity reduction targets. This will increase the likelihood that national targets, and hence China's broader climate change mitigation goals, will be met. - Highlights: • Regional economic disparities are increasing China's national energy intensity. • Regional carbon “outsourcing” is a leading cause of rising energy intensity. • To meet future targets, the “Target Responsibility System” (TRS) needs to be improved. • Regional economic structure should be directly accounted for in energy policy. • Particularly, inland provinces should be assigned higher energy savings targets

Economic Disparities in Middle Childhood Development: Does Income Matter?

Science.gov (United States)

Votruba-Drzal, Elizabeth

2006-01-01

A large literature has documented the influence of family economic resources on child development, yet income's effects in middle childhood have been understudied. Using data from the National Longitudinal Survey of Youth (N = 3,551), the author examined the influence of family income in early and middle childhood on academic skills and…

DEVELOPMENT OF MSW COLLECTION SERVICES ON REGIONAL SCALE: SPATIAL ANALYSIS AND URBAN DISPARITIES IN NORTH-EAST REGION, ROMANIA

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FLORIN-CONSTANTIN MIHAI

2013-05-01

Full Text Available The cities are facing illegal dumping of municipal solid waste (MSW because the waste collection facilities do not cover the entire population. Furthermore, this sector is poorly developed in small towns or villages annexed to administrative territory units (ATU of cities , MSW are disposed in open dumps polluting the local environment. This paper analyzes on the one hand the urban disparities on public access to waste collection services (WCS in the North-East Region on the other hand, it performs a comparative analysis between 2003 and 2010 outlining the changes made in the context of Romania’s accession to EU. Also, it performs a quantitative assessment method of uncollected waste at urban level and correlated to demographic features of each city. Spatial-temporal analysis of waste indicators using thematic cartography or GIS techniques should be a basic tool for environmental monitoring or assessment of projects from this field in every development region (NUTS 2. The EU acquis requires the closure of noncompliant landfills, the extension of waste collection services, the development of facilities for separate collection, recycling and reuse according to waste hierarchy concept. Full coverage of urban population to waste collection services is necessary to provide a proper management of this sector. Urban disparities between counties and within counties highlights that current traditional waste management system is an environmental threat at local and regional scale.

Income, income inequality and youth smoking in low- and middle-income countries.

Science.gov (United States)

Li, David X; Guindon, G Emmanuel

2013-04-01

To examine the relationships between income, income inequality and current smoking among youth in low- and middle-income countries. Pooled cross-sectional data from the Global Youth Tobacco Surveys, conducted in low- and middle-income countries, were used to conduct multi-level logistic analyses that accounted for the nesting of students in schools and of schools in countries. A total of 169 283 students aged 13-15 from 63 low- and middle-income countries. Current smoking was defined as having smoked at least one cigarette in the past 30 days. Gross domestic product (GDP) per capita was our measure of absolute income. Contemporaneous and lagged (10-year) Gini coefficients, as well as the income share ratio of the top decile of incomes to the bottom decile, were our measures of income inequality. Our analyses reveal a significant positive association between levels of income and youth smoking. We find that a 10% increase in GDP per capita increases the odds of being a current smoker by at least 2.5%, and potentially considerably more. Our analyses also suggest a relationship between the distribution of incomes and youth smoking: youth from countries with more unequal distributions of income tend to have higher odds of currently smoking. There is a positive association between gross domestic product and the odds of a young person in a low- and middle-income country being a current smoker. Given the causal links between smoking and a wide range of youth morbidities, the association between smoking and income inequality may underlie a substantial portion of the health disparities observed that are currently experiencing rapid economic growth. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Ethnic and Gender Disparities in Premature Adult Mortality in Belize 2008-2010.

Directory of Open Access Journals (Sweden)

Francis Morey

Full Text Available Data on disparities in mortality within low and middle income countries are limited, with little published data from the Caribbean or Central America. Our aim was to investigate disparities in overall and cause specific premature adult mortality in the multi-ethnic middle income country of Belize.Mortality data from Belize 2008-2010 classified using the International Classification of Diseases 10 and the 2010 census stratified by age and ethnicity were used to calculate age, sex, and ethnic specific mortality rates for those 15-59 years, and life table analysis was used to estimate the probability of death between the ages of 15 and 59 (45q15.The probability of death among those aged 15 to 59 years was 18.1% (women 13.5%, men 22.7%. Creole and Garifuna ethnic groups have three times the 45q15 probability of death compared to Mayan and Mestizo groups (Creole 31.2%, Garifuna 31.1%, Mayan 10.2%, Mestizo 12.0%. This pattern of ethnic disparity existed in both sexes but was greater in men. The probability of death from injuries was 14.8% among Creole men, more than twice the rate of other ethnicities and peaks among young Creole men. These deaths are dominated by homicides and unspecified deaths involving firearms.Marked disparities in mortality between ethnic groups exist in this Central American/Caribbean country, from rates that are typical of high-income countries to those of low-income countries. The pattern of these extreme differences likely suggests that they reflect underlying social determinants rooted in the country's colonial past.

Measuring Poverty at the Regional Level in Spain: A Reflexive Approach

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Nerea Zugasti

2017-01-01

Full Text Available This article assesses the utility of adjusting the poverty threshold for regional areas of Spain and of using thresholds anchored in time. It also offers a critical review of equivalence scales as a central element in estimating poverty. To do this, data from the Income and Living Conditions Surveys from 2007 to 2012 is used. The results show that poverty rates obtained with national thresholds are strongly influenced by intra-regional inequalities in income. They also show that regional thresholds capture differences in the well-being of the population, controlling for the effects of regional disparities in economic development. In addition, they demonstrate that anchored thresholds avoid inconsistencies in poverty rates tied to changes in income levels of the general population and not to changes in socially necessary resources.

Income differentiation of agricultural households in regions of Czech Republic

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Zuzana Procházková

2012-01-01

Full Text Available The Czech Republic has recently experienced phases of economic growth and periods of economic crisis. This fact affects the standard of living and household behaviour and affects the formation of life-style. This paper deals with the income situation of households. The main source of data is EU SILC survey from the years 2005 to 2008. The result of the enquiry and processing of primary data is information about the average income per household member, the poverty level and the number of households at risk of poverty. For the formulation of income differentiation is used Gini coefficient. Attention is paid to factors that affect income inequality (the number of household members, social group, and age. The analysis and subsequent problem solving of income inequality may be contributed with further analysis of empirical data of this type. Household income is one of the decisive factors determining the style of family life, their priorities, meeting their needs, and ensure-time activities. Differences between regions determine preferences and identify opportunities.

The consequences of price differentiation for regional development in Poland

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Grzegorz Przekota

2017-07-01

Full Text Available Each region in Poland has a different economic potential due to its own specific features. Taking account of the specific nature of individual regions is important for the management of the country as a whole and of its particular regions. Existing disparities in the economic development may lead to many negative phenomena, such as internal migration or regional marginalization. Excessive price and income inequalities may weaken economic growth throughout the country. It is important for the coherence of the whole country that the disparities between regions are not too big. The study determines the consequences of price differentiation for regional development in Poland. The analysis was conducted using the coefficient of variation, correlation coefficient, regression coefficient and medium pace. The regions differ in terms of development, dynamic growth and wages. However, prices are much less diverse.

Income Inequality and US Children's Secondhand Smoke Exposure: Distinct Associations by Race-Ethnicity.

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Shenassa, Edmond D; Rossen, Lauren M; Cohen, Jonathan; Morello-Frosch, Rachel; Payne-Sturges, Devon C

2017-11-01

Prior studies have found considerable racial and ethnic disparities in secondhand smoke (SHS) exposure. Although a number of individual-level determinants of this disparity have been identified, contextual determinants of racial and ethnic disparities in SHS exposure remain unexamined. The objective of this study was to examine disparities in serum cotinine in relation to area-level income inequality among 14 649 children from the National Health and Nutrition Examination Survey. We fit log-normal regression models to examine disparities in serum cotinine in relation to Metropolitan Statistical Areas level income inequality among 14 649 nonsmoking children aged 3-15 from the National Health and Nutrition Examination Survey (1999-2012). Non-Hispanic black children had significantly lower serum cotinine than non-Hispanic white children (-0.26; 95% CI: -0.38, -0.15) in low income inequality areas, but this difference was attenuated in areas with high income inequality (0.01; 95% CI: -0.16, 0.18). Serum cotinine declined for non-Hispanic white and Mexican American children with increasing income inequality. Serum cotinine did not change as a function of the level of income inequality among non-Hispanic black children. We have found evidence of differential associations between SHS exposure and income inequality by race and ethnicity. Further examination of environments which engender SHS exposure among children across various racial/ethnic subgroups can foster a better understanding of how area-level income inequality relates to health outcomes such as levels of SHS exposure and how those associations differ by race/ethnicity. In the United States, the association between children's risk of SHS exposure and income inequality is modified by race/ethnicity in a manner that is inconsistent with theories of income inequality. In overall analysis this association appears to be as predicted by theory. However, race-specific analyses reveal that higher levels of income

Reducing Disparities in Tobacco Retailer Density by Banning Tobacco Product Sales Near Schools.

Science.gov (United States)

Ribisl, Kurt M; Luke, Douglas A; Bohannon, Doneisha L; Sorg, Amy A; Moreland-Russell, Sarah

2017-02-01

This study examined whether a policy of banning tobacco product retailers from operating within 1000 feet of schools could reduce existing socioeconomic and racial/ethnic disparities in tobacco retailer density. We geocoded all tobacco retailers in Missouri (n = 4730) and New York (n = 17 672) and linked them with Census tract characteristics. We then tested the potential impact of a proximity policy that would ban retailers from selling tobacco products within 1000 feet of schools. Our results confirmed socioeconomic and racial/ethnic disparities in tobacco retailer density, with more retailers found in areas with lower income and greater proportions of African American residents. A high proportion of retailers located in these areas were in urban areas, which also have stores located in closer proximity to schools. If a ban on tobacco product sales within 1000 feet of schools were implemented in New York, the number of tobacco retailers per 1000 people would go from 1.28 to 0.36 in the lowest income quintile, and from 0.84 to 0.45 in the highest income quintile. In New York and Missouri, a ban on tobacco product sales near schools would either reduce or eliminate existing disparities in tobacco retailer density by income level and by proportion of African American. Proximity-based point of sale (POS) policies banning tobacco product sales near schools appear to be more effective in reducing retailer density in lower income and racially diverse neighborhoods than in higher income and white neighborhoods, and hold great promise for reducing tobacco-related disparities at the POS. Given the disparities-reducing potential of policies banning tobacco product sales near schools, jurisdictions with tobacco retailer licensing should consider adding this provision to their licensing requirements. Since relatively few jurisdictions currently ban tobacco sales near schools, future research should examine ways to increase and monitor the uptake of this policy, and assess

Economic, racial and ethnic disparities in breast cancer in the US: towards a more comprehensive model.

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Campbell, Richard T; Li, Xue; Dolecek, Therese A; Barrett, Richard E; Weaver, Kathryn E; Warnecke, Richard B

2009-09-01

Using cancer registry data, we focus on racial and ethnic disparities in stage of breast cancer diagnosis in Cook County, IL. The county health system is the "last resort" health-care provider for low-income persons. Socioeconomic status is measured using empirical Bayes estimates of tract-level poverty, specific to non-Hispanic whites, non-Hispanic blacks or Hispanics in one of three age groups. We use ordinal logistic regression with non-proportional odds to model stage. Blacks and Hispanics are at greater risk for regional and distant stage diagnosis, but the disparity declines with age. Women in high-poverty areas are at substantially greater risk for late-stage diagnosis. The effects of poverty do not differ by age or across racial and ethnic groups.

Intra-regional disparities in Sisak-Moslavina County

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Zdenko Braičić

2011-06-01

Full Text Available There are distinct discrepancies in social and economic development levels between different parts of the Sisak-Moslavina County. Although discussed in earlier researches, the County's intraregional disparities were approached in a new way. The paper deals with the disparities between administrative cities and municipalities and between the northern (Sisak Posavina and Moslavina and the southern (Banovina part of the County by applying two groups of indicators – economic development and demographic development. Based on these indicators administrative cities and municipalities ranking has been conducted, two synthetic ranks have been derived and their correlation tested. According to different indicators, the Municipality of Gvozd is in the most unfavourable situation while the most favourable indicators are related to the town of Kutina.

Explaining regional disparities in traffic mortality by decomposing conditional probabilities.

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Goldstein, Gregory P; Clark, David E; Travis, Lori L; Haskins, Amy E

2011-04-01

In the USA, the mortality rate from traffic injury is higher in rural and in southern regions, for reasons that are not well understood. For 1754 (56%) of the 3142 US counties, we obtained data allowing for separation of the deaths/population rate into deaths/injury, injuries/crash, crashes/exposure and exposure/population, with exposure measured as vehicle miles travelled. A 'decomposition method' proposed by Li and Baker was extended to study how the contributions of these components were affected by three measures of rural location, as well as southern location. The method of Li and Baker extended without difficulty to include non-binary effects and multiple exposures. Deaths/injury was by far the most important determinant in the county-to-county variation in deaths/population, and accounted for the greatest portion of the rural/urban disparity. After controlling for the rural effect, injuries/crash accounted for most of the southern/northern disparity. The increased mortality rate from traffic injury in rural areas can be attributed to the increased probability of death given that a person has been injured, possibly due to challenges faced by emergency medical response systems. In southern areas, there is an increased probability of injury given that a person has crashed, possibly due to differences in vehicle, road, or driving conditions.

Gender income disparity in the USA: analysis and dynamic modelling

OpenAIRE

Kitov, Ivan; Kitov, Oleg

2015-01-01

We analyze and develop a quantitative model describing the evolution of personal income distribution (PID) for males and females in the U.S. between 1930 and 2014. The overall microeconomic model, which we introduced ten years ago, accurately predicts the change in mean income as a function of age as well as the dependence on age of the portion of people distributed according to the Pareto law. As a result, we have precisely described the change in Gini ratio since the start of income measure...

A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing.

Science.gov (United States)

Lee, Joseph G L; Henriksen, Lisa; Rose, Shyanika W; Moreland-Russell, Sarah; Ribisl, Kurt M

2015-09-01

We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues.

A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing

Science.gov (United States)

Henriksen, Lisa; Rose, Shyanika W.; Moreland-Russell, Sarah; Ribisl, Kurt M.

2015-01-01

We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues. PMID:26180986

Birth outcome racial disparities: A result of intersecting social and environmental factors.

Science.gov (United States)

Burris, Heather H; Hacker, Michele R

2017-10-01

Adverse birth outcomes such as preterm birth, low-birth weight, and infant mortality continue to disproportionately affect black and poor infants in the United States. Improvements in healthcare quality and access have not eliminated these disparities. The objective of this review was to consider societal factors, including suboptimal education, income inequality, and residential segregation, that together lead to toxic environmental exposures and psychosocial stress. Many toxic chemicals, as well as psychosocial stress, contribute to the risk of adverse birth outcomes and black women often are more highly exposed than white women. The extent to which environmental exposures combine with stress and culminate in racial disparities in birth outcomes has not been quantified but is likely substantial. Primary prevention of adverse birth outcomes and elimination of disparities will require a societal approach to improve education quality, income equity, and neighborhoods. Copyright © 2017 Elsevier Inc. All rights reserved.

Urban-rural disparity in utilization of preventive care services in China.

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Liu, Xiang; Li, Ningxiu; Liu, Chaojie; Ren, Xiaohui; Liu, Danping; Gao, Bo; Liu, Yuanyuan

2016-09-01

Preventive care service is considered pivotal on the background of demographic ageing and a rise in chronic diseases in China. The disparity in utilization of preventive care services between urban and rural in China is a serious issue. In this paper, we explored factors associated with urban-rural disparity in utilization of preventive care services in China, and determined how much of the urban-rural disparity was attributable to each determinant of utilization in preventive care services. Using representative sample data from China Health and Nutrition Survey in 2011 (N = 12,976), the present study performed multilevel logistic model to examine the factors that affected utilization of preventive care services in last 4 weeks. Blinder-Oaxaca decomposition method was applied to divide the utilization of preventive care disparity between urban and rural residents into a part that can be explained by differences in observed covariates and unobserved part. The percentage of rural residents utilizing preventive care service in last 4 weeks was lower than that of urban residents (5.1% vs 9.3%). Female, the aged, residents with higher education level and household income, residents reporting self-perceived illness in last 4 weeks and physician-diagnosed chronic disease had higher likelihood of utilizing preventive care services. Household income was the most important factor accounting for 26.6% of urban-rural disparities in utilization of preventive care services, followed by education (21.5%), self-perceived illness in last 4 weeks (7.8%), hypertension (4.4%), diabetes (3.3%), other chronic diseases (0.8%), and health insurance (-1.0%). Efforts to reduce financial barriers for low-income individuals who cannot afford preventive services, increasing awareness of the importance of obtaining preventive health services and providing more preventive health services covered by health insurance, may help to reduce the gap of preventive care services utilization between

Cohort-based income gradients in obesity among U.S. adults.

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Heo, Jongho; Beck, Audrey N; Lin, Shih-Fan; Marcelli, Enrico; Lindsay, Suzanne; Karl Finch, Brian

2018-03-01

No studies have focused on socioeconomic disparities in obesity within and between cohorts. Our objectives were to examine income gradients in obesity between birth-cohorts (inter-cohort variations) and within each birth-cohort (intra-cohort variations) by gender and race/ethnicity. Our sample includes 56,820 white and black adults from pooled, cross-sectional National Health and Nutrition Examination Surveys (1971-2012). We fit a series of logistic hierarchical Age-Period-Cohort models to control for the effects of age and period, simultaneously. Predicted probabilities of obesity by poverty-to-income ratio were estimated and graphed for 5-year cohort groups from 1901-1990. We also stratified this relationship for four gender and racial/ethnic subgroups. Obesity disparities due to income were weaker for post-World War I and II generations, specifically the mid-1920s and the mid-1940s to 1950s cohorts, than for other cohorts. In contrast, we found greater income gradients in obesity among cohorts from the 1930s to mid-1940s and mid-1960s to 1970s. Moreover, obesity disparities due to income across cohorts vary markedly by gender and race/ethnicity. White women with higher income consistently exhibited a lower likelihood of obesity than those with lower income since early 1900s cohorts; whereas, black men with higher income exhibited higher risks of obesity than those with lower income in most cohorts. Our findings suggest that strategies that address race and/or gender inequalities in obesity should be cognizant of significant historical factors that may be unique to cohorts. Period-based approaches that ignore life-course experiences captured in significant cohort-based experiences may limit the utility of policies and interventions. © 2017 Wiley Periodicals, Inc.

Environmental (in)equity in the Netherlands. A case study on the distribution of environmental quality in the Rijnmond region

Energy Technology Data Exchange (ETDEWEB)

Kruize, H.; Bouwman, A.A.

2004-07-01

As a part of a broader investigation on environmental inequity in the Netherlands, an exploratory case study on the socio-economic distribution on (perceived) environmental quality was carried out in the Rijnmond (industrial and urbanised) region in the western part of the Netherlands. Disparities in local environmental quality with respect to noise, air pollution, availability of public green areas, safety risks, and presence of waste disposal sites, were analysed separately and accumulatively across income levels making use of postal codes. Inhabitants' perception of environmental quality with respect to spatial and income differences was also ascertained and analysed. Recent, available national and regional databases and literature were used for the analyses. Disparities in local environmental quality were found to be linked to income level, especially for air pollution and the availability of public green areas. In addition, accumulation of environmental 'goods' (high-quality environmental conditions) were found more often in high-income than in low-income areas. Inhabitants of Rotterdam also mentioned littering and dog mess to be the greatest environmental problem. All income categories experienced annoyance, but from different, often area-specific sources. Considering these results, policy-makers are advised to take the effects of their policy on different income categories into account.

Regional income effects and renewable fuels. Increased usage of renewable energy sources in Danish rural areas and its impact on regional incomes

Energy Technology Data Exchange (ETDEWEB)

Bentzen, J.; Smith, V. [Aarhus School of Business, Dept. of Economics (Denmark); Dilling-Hansen, M. [Univ. of Aarhus, Dept. of Management (Denmark)

1996-12-31

CO{sub 2}-emission is a world wide problem and in the attempt to reduce these emissions, renewable energy sources may be considered serious alternatives to the present usage of fossil fuels. As part of a research programme financed by The Danish Energy Agency, data concerning the different heating technologies based on oil and wood fuels have been collected. Private and social costs are estimated and these economic data are used when analysing regional income effects of increased consumption of fuels (e.g. wood) locally produced. The impacts on income and tax revenues are calculated from multiplier expressions, constructed with rights to the measurement of local effects. (au) 10 refs.

Regional income effects and renewable fuels. Increased usage of renewable energy sources in Danish rural areas and its impact on regional incomes

International Nuclear Information System (INIS)

Bentzen, J.; Smith, V.; Dilling-Hansen, M.

1996-01-01

CO 2 -emission is a world wide problem and in the attempt to reduce these emissions, renewable energy sources may be considered serious alternatives to the present usage of fossil fuels. As part of a research programme financed by The Danish Energy Agency, data concerning the different heating technologies based on oil and wood fuels have been collected. Private and social costs are estimated and these economic data are used when analysing regional income effects of increased consumption of fuels (e.g. wood) locally produced. The impacts on income and tax revenues are calculated from multiplier expressions, constructed with rights to the measurement of local effects. (au) 10 refs

The regional income and employment impacts of nuclear power stations

International Nuclear Information System (INIS)

McGuire, A.

1982-01-01

This paper attempts quantitatively to assess the income and employment impacts associated with two nuclear establishments in Scotland: the United Kingdom Atomic Energy Authority (U.K.A.E.A.) nuclear power establishment at Dounreay in Caithness and the South of Scotland Electricity Board (S.S.E.B.) nuclear power station presently under construction at Torness in the Lothian region. The model used is a basic Keynesian income multiplier model refined to allow detailed analysis of income and employment impacts at a local level. As used in this study it allows the identification of the increase in income and the associated increase in employment relating to the siting of a nuclear power plant in a particular locality. Results are given. The employment multipliers are estimated to be in the range 1.236 to 1.535 for Dounreay and 1.294 to 1.675 for the operational phase of the Torness plant. It is concluded that although the absolute income increases in the respective subregions are significant, compared to the total annual expenditure of the establishments these figures indicate high leakage from the subregions. (UK)

Disparities in Hypertension Prevalence, Awareness, Treatment and Control between Bouyei and Han: Results from a Bi-Ethnic Health Survey in Developing Regions from South China.

Science.gov (United States)

Dong, Fen; Wang, Dingming; Pan, Li; Yu, Yangwen; Wang, Ke; Li, Ling; Wang, Li; Liu, Tao; Zeng, Xianjia; Sun, Liangxian; Zhu, Guangjin; Feng, Kui; Zhang, Biao; Xu, Ke; Pang, Xinglong; Chen, Ting; Pan, Hui; Ma, Jin; Zhong, Yong; Ping, Bo; Shan, Guangliang

2016-02-19

Hypertension is highly prevalent in low-income population. This study aims to investigate ethnic disparities in hypertension and identify modifiable factors related to its occurrence and control in developing regions in South China. Blood pressure was measured in the Bouyei and Han populations during a community-based health survey in Guizhou, 2012. A multistage stratified sampling method was adopted to recruit Bouyei and Han aged from 20 to 80 years. Taking mixed effects into consideration, multilevel logistic models with random intercept were used for data analysis. The prevalence rates of hypertension were 35.3% for the Bouyei and 33.7% for the Han. Among the hypertensive participants, 30.1% of the Bouyei and 40.2% of the Han were aware of their hypertensive conditions, 19.7% of the Bouyei and 31.1% of the Han were receiving treatment, and only 3.6% of the Bouyei and 9.9% of the Han had their blood pressure under control. Age-sex standardized rates of awareness, treatment, and control were consistently lower in the Bouyei than the Han. Such ethnic disparities were more evident in the elderly population. Avoidance of excessive alcohol consumption and better education were favorable lifestyle for reduction in risk of hypertension. Moderate physical activity improved control of hypertension in Bouyei patients under treatment. Conclusively, hypertension awareness, treatment, and control were substantially lower in Bouyei than Han, particularly in the elderly population. Such ethnic disparities indicate that elderly Bouyei population should be targeted for tailored interventions in the future.

Socially disparate trends in lifespan variation

DEFF Research Database (Denmark)

Brønnum-Hansen, Henrik

2017-01-01

BACKGROUND: Social inequality trends in life expectancy are not informative as to changes in social disparity in the age-at-death distribution. The purpose of the study was to investigate social differentials in trends and patterns of adult mortality in Denmark. METHODS: Register data on income...... quartile. The results do not provide support for a uniformly extension of pension age for all....

Stillbirths 5. Stillbirths : the way forward in high-income countries

NARCIS (Netherlands)

Flenady, Vicki; Middleton, Philippa; Smith, Gordon C.; Duke, Wes; Erwich, Jan Jaap; Khong, T. Yee; Neilson, Jim; Ezzati, Majid; Koopmans, Laura; Ellwood, David; Fretts, Ruth; Froen, J. Frederik

2011-01-01

Stillbirth rates in high-income countries declined dramatically from about 1940, but this decline has slowed or stalled over recent times. The present variation in stillbirth rates across and within high-income countries indicates that further reduction in stillbirth is possible. Large disparities

Magnitude of income-related disparities in adverse perinatal outcomes.

Science.gov (United States)

Shankardass, Ketan; O'Campo, Patricia; Dodds, Linda; Fahey, John; Joseph, Ks; Morinis, Julia; Allen, Victoria M

2014-03-04

To assess and compare multiple measurements of socioeconomic position (SEP) in order to determine the relationship with adverse perinatal outcomes across various contexts. A birth registry, the Nova Scotia Atlee Perinatal Database, was confidentially linked to income tax and related information for the year in which delivery occurred. Multiple logistic regression was used to examine odds ratios between multiple indicators of SEP and multiple adverse perinatal outcomes in 117734 singleton births between 1988 and 2003. Models for after tax family income were also adjusted for neighborhood deprivation to gauge the relative magnitude of effects related to SEP at both levels. Effects of SEP were stratified by single- versus multiple-parent family composition, and by urban versus rural location of residence. The risk of small for gestational age and spontaneous preterm birth was higher across all the indicators of lower SEP, while risk for large for gestational age was lower across indicators of lower SEP. Higher risk of postneonatal death was demonstrated for several measures of lower SEP. Higher material deprivation in the neighborhood of residence was associated with increased risk for perinatal death, small for gestational age birth, and iatrogenic and spontaneous preterm birth. Family composition and urbanicity were shown to modify the association between income and some perinatal outcomes. This study highlights the importance of understanding the definitions of SEP and the mechanisms that lead to the association between income and poor perinatal outcomes, and broadening the types of SEP measures used in some cases.

Shedding Light on the Mechanisms Underlying Health Disparities Through Community Participatory Methods: The Stress Pathway

Science.gov (United States)

Schetter, Christine Dunkel; Schafer, Peter; Lanzi, Robin Gaines; Clark-Kauffman, Elizabeth; Raju, Tonse N. K.; Hillemeier, Marianne M.

2015-01-01

Health disparities are large and persistent gaps in the rates of disease and death between racial/ethnic and socioeconomic status subgroups in the population. Stress is a major pathway hypothesized to explain such disparities. The Eunice Kennedy Shriver National Institute of Child Health and Human Development formed a community/research collaborative—the Community Child Health Network—to investigate disparities in maternal and child health in five high-risk communities. Using community participation methods, we enrolled a large cohort of African American/Black, Latino/Hispanic, and non-Hispanic/White mothers and fathers of newborns at the time of birth and followed them over 2 years. A majority had household incomes near or below the federal poverty level. Home interviews yielded detailed information regarding multiple types of stress such as major life events and many forms of chronic stress including racism. Several forms of stress varied markedly by racial/ethnic group and income, with decreasing stress as income increased among Caucasians but not among African Americans; other forms of stress varied by race/ethnicity or poverty alone. We conclude that greater sophistication in studying the many forms of stress and community partnership is necessary to uncover the mechanisms underlying health disparities in poor and ethnic-minority families and to implement community health interventions. PMID:26173227

Minimum Wages and Regional Disparity: An analysis on the evolution of price-adjusted minimum wages and their effects on firm profitability (Japanese)

OpenAIRE

MORIKAWA Masayuki

2013-01-01

This paper, using prefecture level panel data, empirically analyzes 1) the recent evolution of price-adjusted regional minimum wages and 2) the effects of minimum wages on firm profitability. As a result of rapid increases in minimum wages in the metropolitan areas since 2007, the regional disparity of nominal minimum wages has been widening. However, the disparity of price-adjusted minimum wages has been shrinking. According to the analysis of the effects of minimum wages on profitability us...

Ecological Pressure of Carbon Footprint in Passenger Transport: Spatio-Temporal Changes and Regional Disparities

Directory of Open Access Journals (Sweden)

Fei Ma

2018-01-01

Full Text Available Passenger transport has become a significant producer of carbon emissions in China, thus strongly contributing to climate change. In this paper, we first propose a model of ecological pressure of the carbon footprint in passenger transport (EPcfpt. In the model, the EPcfpt values of all the provinces and autonomous regions of China are calculated and analyzed during the period of 2006–2015. For the outlier EPcfpt values of Beijing, Shanghai and Tianjin, the research areas are classified into two scenarios: the first scenario (all the provinces and autonomous regions and the second scenario (not including Beijing, Shanghai and Tianjin. The global spatial autocorrelation analysis of the first scenario shows that the EPcfpt might be randomly distributed, while it shows positive spatial autocorrelation in the second scenario. Furthermore, we carry out the local spatial autocorrelation analysis of the second scenario, and find that the low aggregation areas are the most common type and are mainly located in the west of China. Then the disparities in EPcfpt between China’s Eight Comprehensive Economic Zones are further analyzed. Finally, we put forward a number of policy recommendations in relation to the spatio-temporal changes and the regional disparities of EPcfpt in China. This study provides related references for proposing effective policy measures to reduce the ecological pressure of carbon emissions from the passenger transport sector.

Data science for assessing possible tax income manipulation: The case of Italy

Science.gov (United States)

Ausloos, Marcel; Cerqueti, Roy; Mir, Tariq A.

2017-11-01

This paper explores a real-world fundamental theme under a data science perspective. It specifically discusses whether fraud or manipulation can be observed in and from municipality income tax size distributions, through their aggregation from citizen fiscal reports. The study case pertains to official data obtained from the Italian Ministry of Economics and Finance over the period 2007-2011. All Italian (20) regions are considered. The considered data science approach concretizes in the adoption of the Benford first digit law as quantitative tool. Marked disparities are found, - for several regions, leading to unexpected "conclusions". The most eye browsing regions are not the expected ones according to classical imagination about Italy financial shadow matters.

Disparities in the Use of Radiation Therapy in Patients With Local-Regionally Advanced Breast Cancer

International Nuclear Information System (INIS)

Martinez, Steve R.; Beal, Shannon H.; Chen, Steven L.; Canter, Robert J.; Khatri, Vijay P.; Chen, Allen; Bold, Richard J.

2010-01-01

Background: Radiation therapy (RT) is indicated for the treatment of local-regionally advanced breast cancer (BCa). Hypothesis: We hypothesized that black and Hispanic patients with local-regionally advanced BCa would receive lower rates of RT than their white counterparts. Methods: The Surveillance Epidemiology and End Results database was used to identify white, black, Hispanic, and Asian patients with invasive BCa and ≥10 metastatic lymph nodes diagnosed between 1988 and 2005. Univariate and multivariate logistic regression evaluated the relationship of race/ethnicity with use of RT. Multivariate models stratified for those undergoing mastectomy or lumpectomy. Results: Entry criteria were met by 12,653 patients. Approximately half of the patients did not receive RT. Most patients were white (72%); the remainder were Hispanic (10.4%), black (10.3%), and Asian (7.3%). On univariate analysis, Hispanics (odd ratio [OR] 0.89; 95% confidence interval [CI], 0.79-1.00) and blacks (OR 0.79; 95% CI, 0.70-0.89) were less likely to receive RT than whites. On multivariate analysis, blacks (OR 0.76; 95% CI, 0.67-0.86) and Hispanics (OR 0.80; 95% CI, 0.70-0.90) were less likely than whites to receive RT. Disparities persisted for blacks (OR 0.74; 95% CI, 0.64-0.85) and Hispanics (OR 0.77; 95% CI, 0.67-0.89) who received mastectomy, but not for those who received lumpectomy. Conclusions: Many patients with local-regionally advanced BCa do not receive RT. Blacks and Hispanics were less likely than whites to receive RT. This disparity was noted predominately in patients who received mastectomy. Future efforts at improving rates of RT are warranted. Efforts at eliminating racial/ethnic disparities should focus on black and Hispanic candidates for postmastectomy RT.

Climate change and water scarcity effects on the rural income distribution in the Mediterranean

Science.gov (United States)

Quiroga, Sonia; Suárez, Cristina

2015-04-01

This paper examines the effects of climate change and water scarcity on the agricultural outputs in the Mediterranean region. By now the effects of water scarcity as a response to climate change or policy restrictions has been analyzed with response functions considering the direct effects on crop productivity. Here we consider a complementary indirect effect on social distribution of incomes which is essential in the long term. We estimate crop production functions for a range of Mediterranean crops in Spain and we use a decomposition of the Gini coefficient to estimate the impact of climate change and water scarcity on yield disparities. This social aspect is important for climate change policies since it can be determinant for the public acceptation of certain adaptation measures in a context of water scarcity. We provide the empirical estimations for the marginal effects on the two considered direct and indirect impacts. In our estimates we consider both bio-physical and socio-economic aspects to conclude that there are long term implications on both competitiveness and social disparities. We find disparities in the adaptation strategies depending on the crop and the region analyzed.

Income and employment effects of shale gas extraction windfalls: Evidence from the Marcellus region

International Nuclear Information System (INIS)

Paredes, Dusan; Komarek, Timothy; Loveridge, Scott

2015-01-01

New technologies combining hydraulic fracturing and horizontal drilling in oil and gas extraction are creating a sudden expansion of production. Residents of places where deep underground oil and gas deposits are found want to know about the broader economic, social, and environmental impacts of these activities that generate windfall income for some residents. We first review the literature on windfall spending patterns. Then, using the Marcellus region, the earliest area to be tapped using the new techniques, we estimate county-level employment and income effects. For robustness, we employ two methods. Using a propensity score matching approach we find no effect of fracking on income or employment. A panel-fixed effect regression approach suggests statistically significant employment effects in six out of seven alternative specifications, but significant income effects in only one out of seven specifications. In short, the income spillover effects in the Marcellus region appear to be minimal, meaning there's little incentive at the county level to incur current or potential future costs that may be associated with this activity. We conclude with some ideas on how localities might employ policies that would allow natural gas extraction to move forward, benefitting landowners, while establishing some financial safeguards for the broader community. - Highlights: • We examine the effect of fracking on local employment and income. • The differing policies in the Marcellus region provide a natural policy experiment. • Propensity score matching shows no income or employment growth from fracking. • Panel data estimates show weak impacts on employment and income. • We suggest ways to address possible future environmental consequences

Addressing the Social Determinants of Health to Reduce Tobacco-Related Disparities.

Science.gov (United States)

Garrett, Bridgette E; Dube, Shanta R; Babb, Stephen; McAfee, Tim

2015-08-01

Comprehensive tobacco prevention and control efforts that include implementing smoke-free air laws, increasing tobacco prices, conducting hard-hitting mass media campaigns, and making evidence-based cessation treatments available are effective in reducing tobacco use in the general population. However, if these interventions are not implemented in an equitable manner, certain population groups may be left out causing or exacerbating disparities in tobacco use. Disparities in tobacco use have, in part, stemmed from inequities in the way tobacco control policies and programs have been adopted and implemented to reach and impact the most vulnerable segments of the population that have the highest rates of smokings (e.g., those with lower education and incomes). Education and income are the 2 main social determinants of health that negatively impact health. However, there are other social determinants of health that must be considered for tobacco control policies to be effective in reducing tobacco-related disparities. This article will provide an overview of how tobacco control policies and programs can address key social determinants of health in order to achieve equity and eliminate disparities in tobacco prevention and control. Tobacco control policy interventions can be effective in addressing the social determinants of health in tobacco prevention and control to achieve equity and eliminate tobacco-related disparities when they are implemented consistently and equitably across all population groups. Taking a social determinants of health approach in tobacco prevention and control will be necessary to achieve equity and eliminate tobacco-related disparities. © The Author 2014. 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.

Regional Disparities in Education Attainment Level in the European Union: A Spatial Approach

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Chocholatá Michaela

2017-10-01

Full Text Available This article deals with the analysis of education attainment level across the 252 NUTS 2 regions of the European Union (EU with consideration of the spatial aspect. Since the individual EU regions cannot be seen as isolated, the main aim of this article is to assess the impact of location on the education attainment level (percentage of population aged 25–64 with at least upper secondary education during the period 2007–2015, as well as to investigate the impact of regional growth 2014/2007 on the education attainment level in 2015. The spatial analysis proved the existence of positive spatial autocorrelation and persistence of disparities in education attainment level across EU regions during the analysed period. The results of econometric analysis confirmed the expected positive impact of economic growth on education attainment level as well as the necessity to incorporate the spatial dimension into the model.

Income and Well-Being: Relative Income and Absolute Income Weaken Negative Emotion, but Only Relative Income Improves Positive Emotion.

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Yu, Zonghuo; Chen, Li

2016-01-01

Whether relative income or absolute income could affect subjective well-being has been a bone of contention for years. Life satisfaction and the relative frequency of positive and negative emotions are parts of subjective well-being. According to the prospect theory, hedonic adaptation helps to explain why positive emotion is often so hard to be maintained, and negative emotion wouldn't be easy to be eliminated. So we expect the relationship between income and positive emotion is different from that between income and negative emotion. Given that regional reference is the main comparison mechanism, effects of regional average income on regional average subjective well-being should be potentially zero if only relative income matters. Using multilevel analysis, we tested the hypotheses with a dataset of 30,144 individuals from 162 counties in China. The results suggested that household income at the individual level is associated with life satisfaction, happiness and negative emotions. On the contrary, at a county level, household income is only associated with negative emotion. In other words, happiness and life satisfaction was only associated with relative income, but negative emotion was associated with relative income and absolute income. Without social comparison, income doesn't improve happiness, but it could weaken negative emotion. Therefore, it is possible for economic growth to weaken negative emotion without improving happiness. These findings also contribute to the current debate about the "Esterling paradox."

Shedding Light on the Mechanisms Underlying Health Disparities Through Community Participatory Methods: The Stress Pathway.

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Dunkel Schetter, Christine; Schafer, Peter; Lanzi, Robin Gaines; Clark-Kauffman, Elizabeth; Raju, Tonse N K; Hillemeier, Marianne M

2013-11-01

Health disparities are large and persistent gaps in the rates of disease and death between racial/ethnic and socioeconomic status subgroups in the population. Stress is a major pathway hypothesized to explain such disparities. The Eunice Kennedy Shriver National Institute of Child Health and Human Development formed a community/research collaborative-the Community Child Health Network-to investigate disparities in maternal and child health in five high-risk communities. Using community participation methods, we enrolled a large cohort of African American/Black, Latino/Hispanic, and non-Hispanic/White mothers and fathers of newborns at the time of birth and followed them over 2 years. A majority had household incomes near or below the federal poverty level. Home interviews yielded detailed information regarding multiple types of stress such as major life events and many forms of chronic stress including racism. Several forms of stress varied markedly by racial/ethnic group and income, with decreasing stress as income increased among Caucasians but not among African Americans; other forms of stress varied by race/ethnicity or poverty alone. We conclude that greater sophistication in studying the many forms of stress and community partnership is necessary to uncover the mechanisms underlying health disparities in poor and ethnic-minority families and to implement community health interventions. © The Author(s) 2013.

Geographical Information Systems Assessment of Development Disparities Among Romanian Regions of Development

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SORIN DANIEL MANOLE

2012-01-01

Full Text Available New strategies of the European Union, focused directly on regional development or originated from different areas, but leading to changes in this field, had resulted into a set of indices used to monitor the effects of their implementation. Previous studies suggest that flexible systems perform better and could strengthen the administrative capacity of accessing structural and cohesion funds. Our study used the Geographical Information Systems (GIS to produce hierarchies of the territorial indices at NUTS level II, displayed as charts and maps underlining the disparities between the socioeconomic, cultural and environmental aspects of the development. The results suggest that the regions with a low potential of development are situated in the south of Romania, but, most important, underline the potential of the method to be used as a planning tool in regional development, as its flexibility allows for an input with particular focus from different stakeholders, resulting into the selection of different indices and weights.

A multi-model assessment of regional climate disparities caused by solar geoengineering

International Nuclear Information System (INIS)

Kravitz, Ben; Rasch, Philip J; Singh, Balwinder; Yoon, Jin-Ho; MacMartin, Douglas G; Robock, Alan; Ricke, Katharine L; Cole, Jason N S; Curry, Charles L; Irvine, Peter J; Ji, Duoying; Moore, John C; Keith, David W; Egill Kristjánsson, Jón; Muri, Helene; Tilmes, Simone; Watanabe, Shingo; Yang, Shuting

2014-01-01

Global-scale solar geoengineering is the deliberate modification of the climate system to offset some amount of anthropogenic climate change by reducing the amount of incident solar radiation at the surface. These changes to the planetary energy budget result in differential regional climate effects. For the first time, we quantitatively evaluate the potential for regional disparities in a multi-model context using results from a model experiment that offsets the forcing from a quadrupling of CO 2 via reduction in solar irradiance. We evaluate temperature and precipitation changes in 22 geographic regions spanning most of Earth's continental area. Moderate amounts of solar reduction (up to 85% of the amount that returns global mean temperatures to preindustrial levels) result in regional temperature values that are closer to preindustrial levels than an un-geoengineered, high CO 2 world for all regions and all models. However, in all but one model, there is at least one region for which no amount of solar reduction can restore precipitation toward its preindustrial value. For most metrics considering simultaneous changes in both variables, temperature and precipitation values in all regions are closer to the preindustrial climate for a moderate amount of solar reduction than for no solar reduction. (letter)

Income and Wealth Inequality in America, 1949-2013

OpenAIRE

Kuhn, Moritz; Schularick, Moritz; Steins, Ulrike I.

2017-01-01

This paper studies the distribution of U.S. household income and wealth over the past seven decades. We introduce a newly compiled household-level dataset based on archival data from historical waves of the Survey of Consumer Finances (SCF). Complementing recent work on top income and wealth shares, the long-run survey data give a granular picture of trends in the bottom 90% of the population. The new data confirm a substantial widening of income and wealth disparities since the 1970s. We sho...

Association between income and the hippocampus.

Directory of Open Access Journals (Sweden)

Jamie L Hanson

2011-05-01

Full Text Available Facets of the post-natal environment including the type and complexity of environmental stimuli, the quality of parenting behaviors, and the amount and type of stress experienced by a child affects brain and behavioral functioning. Poverty is a type of pervasive experience that is likely to influence biobehavioral processes because children developing in such environments often encounter high levels of stress and reduced environmental stimulation. This study explores the association between socioeconomic status and the hippocampus, a brain region involved in learning and memory that is known to be affected by stress. We employ a voxel-based morphometry analytic framework with region of interest drawing for structural brain images acquired from participants across the socioeconomic spectrum (n = 317. Children from lower income backgrounds had lower hippocampal gray matter density, a measure of volume. This finding is discussed in terms of disparities in education and health that are observed across the socioeconomic spectrum.

Income from Women’s Gainful Employment Compared to Household Income

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Ulman Paweł

2014-06-01

Full Text Available Various statistical analyses reveal that the position of women in the labour market is worse when compared to men. In the majority, or nearly in all countries of the EU, women obtain lower income than men and are in a greater risk of becoming unemployed. The problem of such differentiation in the labour market is still valid despite the various activities at the EU agenda aimed at reducing these disparities. The aim of this paper was to present the income situation of women who remain in a formal or informal relationship with men and to identify the factors which affect such a situation without making any reference to the problem of discrimination. The author used the data from Polish household budget survey of 2011.

Environmental Equity and the Role of Public Policy: Experiences in the Rijnmond Region

Science.gov (United States)

Kruize, Hanneke; Driessen, Peter P. J.; Glasbergen, Pieter; van Egmond, Klaas (N. D.)

2007-10-01

This Φ Ψ study of environmental equity uses secondary quantitative data to analyze socioeconomic disparities in environmental conditions in the Rijnmond region of the Netherlands. The disparities of selected environmental indicators—exposure to traffic noise (road, rail, and air), NO2, external safety risks, and the availability of public green space—are analyzed both separately and in combination. Not only exposures to environmental burdens (“bads”) were investigated, but also access to environmental benefits (“goods”). Additionally, we held interviews and reviewed documents to grasp the mechanisms underlying the environmental equity situation, with an emphasis on the role of public policy. Environmental equity is not a priority in public policy for the greater Rotterdam region known as the Rijnmond region, yet environmental standards have been established to provide a minimum environmental quality to all local residents. In general, environmental quality has improved in this region, and the accumulation of negative environmental outcomes (“bads”) has been limited. However, environmental standards for road traffic noise and NO2 are being exceeded, probably because of the pressure on space and the traffic intensity. We found an association of environmental “bads” with income for rail traffic noise and availability of public green space. In the absence of regulation, positive environmental outcomes (“goods”) are mainly left up to market forces. Consequently, higher-income groups generally have more access to environmental “goods” than lower-income groups.

Examining Measures of Income and Poverty in Medicare Administrative Data.

Science.gov (United States)

Samson, Lok Wong; Finegold, Kenneth; Ahmed, Azeem; Jensen, Matthew; Filice, Clara E; Joynt, Karen E

2017-12-01

Disparities by economic status are observed in the health status and health outcomes of Medicare beneficiaries. For health services and health policy researchers, one barrier to addressing these disparities is the ability to use Medicare data to ascertain information about an individual's income level or poverty, because Medicare administrative data contains limited information about individual economic status. Information gleaned from other sources-such as the Medicaid and Supplemental Security Income programs-can be used in some cases to approximate the income of Medicare beneficiaries. However, such information is limited in its availability and applicability to all beneficiaries. Neighborhood-level measures of income can be used to infer individual-level income, but level of neighborhood aggregation impacts accuracy and usability of the data. Community-level composite measures of economic status have been shown to be associated with health and health outcomes of Medicare beneficiaries and may capture neighborhood effects that are separate from individual effects, but are not readily available in Medicare data and do not serve to replace information about individual economic status. There is no single best method of obtaining income data from Medicare files, but understanding strengths and limitations of different approaches to identifying economic status will help researchers choose the best method for their particular purpose, and help policymakers interpret studies using measures of income.

Reduction in Vegetable Intake Disparities With a Web-Based Nutrition Education Intervention Among Lower-Income Adults in Japan: Randomized Controlled Trial.

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Nakamura, Saki; Inayama, Takayo; Harada, Kazuhiro; Arao, Takashi

2017-11-24

No existing Web-based nutrition education interventions have been evaluated in light of socioeconomic status just in Japan. The aim was to investigate the effect of a Web-based intervention program on reducing vegetable intake disparities between low- and middle-income Japanese adults. In this randomized controlled trial, participants were assessed at three time points-baseline, postintervention (5 weeks later), and a follow-up after 3 months-from October 2015 to March 2016. We collected data via a Japanese online research service company from 8564 adults aged 30 to 59 years. Participants were stratified according to national population statistics for gender and age, and randomly selected. They were then randomly allocated into intervention (n=900) and control (n=600) groups such that both groups contained an equal number of individuals with low and middle income. The intervention program encouraged behavior change using behavioral theories and techniques tailored to their assumed stage of change. The outcome was vegetable intake servings per day (1 serving being approximately 70 g). Out of 900 participants who started, 450 were from the middle income group (of which 386 or 85.7% completed the intervention), and 450 were from the low income group (of which 371 or 82.4% completed). In the intervention group, vegetable intake increased in the low-income participants from baseline to postintervention (0.42 servings, 95% CI 0.11-0.72). A two-way analysis of variance showed that low-income participants had significant main effects of group (η2=0.04, P=.01) and time (η2=0.01, Pincome participants also had a significant main effect of time (η2=0.01, P=.006) and a significant interaction (η2=0.01, P=.046). This Web-based nutritional education intervention could fill the vegetable intake gap between low- and middle-income adults in Japan, and is expected to prevent noncommunicable and lifestyle-related diseases. Further intervention program improvements are necessary to

ANALYSIS OF DIRECT AND INDIRECT EFFECTS OF FISCAL DECENTRALIZATION ON REGIONAL DISPARITY (CASE STUDY OF PROVINCES IN EASTERN AND WESTERN OF INDONESIA, 2006-2015

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Faishal Fadli

2016-12-01

Full Text Available This study aimed to examine the direct and indirect effects of fiscal decentralization on regional disparity through economic growth in eastern and western Indonesia. The method used in this study is Path Analysis. The variables used in this study include the General Allocation Fund (DAU/Dana Alokasi Umum, Special Allocation Fund (DAK/Dana Alokasi Khusus, Revenue Sharing Fund (DBH/Dana Bagi Hasil, local revenue (PAD/Pendapatan Asli Daerah, Economic Growth (G, and regional disparity (IW. Comparing the analysis between eastern and western of Indonesia, the results show that there is no direct effect of fiscal decentralization on regional disparity and economic growth through direct fiscal decentralization on regional disparity in both eastern and western of Indonesia. However, using some measures of fiscal decentralization, in the case of eastern of Indonesia, DAU variable has significant effect whereas in the case of western Indonesia, DBH is the only one variable that has significant effect. This is consistent with the fact that composition of the balance funds disbursed by the central government to local governments, where the greatest composition of funds in eastern Indonesia come from the General Allocation Fund which reflects the dependence of local governments to the central government and for the western region of Indonesia, DBH is the greatest reflecting the independence of the local governments. As a result, to create fiscal decentralization working it is required a greater allocation of the fund balance.

Socioeconomic disparities in breast cancer screening in Hawaii.

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Halliday, Timothy; Taira, Deborah A; Davis, James; Chan, Henry

2007-10-01

Despite evidence that breast cancer screening reduces morbidity and mortality, many women do not obtain mammograms. Our objective was to analyze the relationship between income and mammography screening for members enrolled in a large health plan in Hawaii. We analyzed claims data for women (N = 46,328) aged 50 to 70 years during 2003 and 2004. We used parametric and nonparametric regression techniques. We used probit estimation to conduct multivariate analysis. At the 5th percentile of the earnings distribution, the probability of mammography is 57.1%, and at the 95th percentile, it is 67.7%. Movement from the 5th percentile to the 35th percentile of the earnings distribution increases the probability of mammography by 0.0378 percentage points. A similar movement from the 65th percentile to the 95th percentile increases the probability by 0.0394 percentage points. Also, we observed an income gradient within narrowly defined geographic regions where physical access to medical care providers is not an issue. We observed a steep income gradient in mammography screening in Hawaii. Because of the prevalence of measurement error, this gradient is probably far greater than our estimate. We cannot plausibly attribute our findings to disparities in coverage because 100% of our sample had health insurance coverage. The gradient also does not appear to result from poorer people residing in areas that are geographically isolated from providers of medical care.

Relationships between cancer pattern, country income and geographical region in Asia.

Science.gov (United States)

Ng, Chirk Jenn; Teo, Chin Hai; Abdullah, Nurdiana; Tan, Wei Phin; Tan, Hui Meng

2015-09-03

Cancer incidence and mortality varies across region, sex and country's economic status. While most studies focused on global trends, this study aimed to describe and analyse cancer incidence and mortality in Asia, focusing on cancer site, sex, region and income status. Age-standardised incidence and mortality rates of cancer were extracted from the GLOBOCAN 2012 database. Cancer mortality to incidence ratios (MIRs) were calculated to represent cancer survival. The data were analysed based on the four regions in Asia and income. Cancer incidence rate is lower in Asia compared to the West but for MIR, it is the reverse. In Asia, the most common cancers in men are lung, stomach, liver, colorectal and oesophageal cancers while the most common cancers in women are breast, lung, cervical, colorectal and stomach cancers. The MIRs are the highest in lung, liver and stomach cancers and the lowest in colorectal, breast and prostate cancers. Eastern and Western Asia have a higher incidence of cancer compared to South-Eastern and South-Central Asia but this pattern is the reverse for MIR. Cancer incidence rate increases with country income particularly in colorectal and breast cancers but the pattern is the opposite for MIR. This study confirms that there is a wide variation in cancer incidence and mortality across Asia. This study is the first step towards documenting and explaining the changing cancer pattern in Asia in comparison to the rest of the world.

Rural Health Disparities

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... in the Delta Region for specific data. U.S. – Mexico Border While life expectancy in many counties of ... documents the successes, challenges, and relevant information for planning. ... on rural/urban disparities see What sources cover health behaviors and ...

Contribution of weight status to asthma prevalence racial disparities, 2-19 year olds, 1988-2014.

Science.gov (United States)

Akinbami, Lara J; Rossen, Lauren M; Fakhouri, Tala H I; Simon, Alan E; Kit, Brian K

2017-08-01

Racial disparities in childhood asthma prevalence increased after the 1990s. Obesity, which also varies by race/ethnicity, is an asthma risk factor but its contribution to asthma prevalence disparities is unknown. We analyzed nationally representative National Health Examination and Nutrition Survey data for 2-19 year olds with logistic regression and decomposition analyses to assess the contributions of weight status to racial disparities in asthma prevalence, controlling for sex, age, and income status. From 1988-1994 to 2011-2014, asthma prevalence increased more among non-Hispanic black (NHB) (8.4% to 18.0%) than non-Hispanic white (NHW) youth (7.2% to 10.3%). Logistic regression showed that obesity was an asthma risk factor for all groups but that a three-way "weight status-race/ethnicity-time" interaction was not significant. That is, weight status did not modify the race/ethnicity association with asthma over time. In decomposition analyses, weight status had a small contribution to NHB/NHW asthma prevalence disparities but most of the disparity remained unexplained by weight status or other asthma risk factors (sex, age and income status). NHB youth had a greater asthma prevalence increase from 1988-1994 to 2011-2014 than NHW youth. Most of the racial disparity in asthma prevalence remained unexplained after considering weight status and other characteristics. Published by Elsevier Inc.

An analysis of changes in Chinese migrants' income.

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Wang, Y

1990-01-01

Migration in China is analyzed in terms of migration income, the effect of changes in income on migratory behavior before and after economic reforms, and a comparison of migrants' income by city size (metropolis; large, medium, or small city; and town). Data were obtained from the 1986 sample survey of 74 cities and towns and population migration. Migration is defined as crossing over an administrative urban area from an original place of residence for more than 1 year, regardless of whether the residence permit was changes or not. Monthly income/capita in 1978 and 1986 is the income measure. Correlations between income and migration generated by the Q index reveal that there is a positive correlation between migratory behavior and individual income in the urban population such that migrants income is higher than nonmigrants. The correlation becomes stronger over time, such that migrants' income is higher in 1986 than nonmigrants' in 1986. Correlation in 1978 was .191 and .341 in 1986, which indicates a weak relationship. The interpretation is that migrants move to increase income level, which is supported by research in the US and the USSR. The cultural and age composition of the migrant population also suggests that those with stronger capabilities are migrants. There is also regional disparity in workers' salaries, and the permit system before 1978 was restrictive. The stronger correlation in 1986 is attributed to policy changes and an increased level of socioeconomic development and ownership structure. The generally weak correlation is attributed to the state of developing economy where there does not yet exist full scale freedom of mobility, a full scale open labor market, or full scale competition for employment. There are 2 categories of population employment: salaried employees and gross national product i.e., one sector is protected by state economic and social welfare policies and another sector which is under restrictions. This phenomena is explicated

Economic Growth, Convergence and Innovation in the EU Regions

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Tiiu Paas

2012-12-01

Full Text Available The paper focuses on quantitative assessment of the innovation’s role in explaining regional disparities and convergence in Europe. The empirical part of the study bases on the regional GDP pc and innovation indicators on the EU-27 NUTS2 level regions. Based on the selected set of initial regional innovation indicators and using the principal components factor analysis method, three composite indicators of regional innovation capacity are extracted. Estimating convergence equations, we noticed that regional innovations tend to increase inter-regional differences, at least during the short-run period. Thus, if regional income convergence is a policy target, additional policy measures beside innovation activities should be effectively implemented.

Urban poverty and infant mortality rate disparities.

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Sims, Mario; Sims, Tammy L; Bruce, Marino A

2007-04-01

This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity.

Regional disparity of urban passenger transport associated GHG (greenhouse gas) emissions in China: A review

International Nuclear Information System (INIS)

Hao, Han; Geng, Yong; Wang, Hewu; Ouyang, Minggao

2014-01-01

With China’s urbanization and motorization, greenhouse gas (GHG) emissions from urban passenger transport increased rapidly over recent years. As we estimated, China’s urban passenger transport associated motorized travel, energy consumption and lifecycle GHG emissions reached 2815 billion passenger kilometers (pkm), 77 million tons of oil equivalent (toe) and 335 million ton CO 2 equivalent in 2010, over half of which were located in eastern provinces. Over national level, GHG emissions by private passenger vehicles, business passenger vehicles, taxis, motorcycles, E-bikes, transit buses and urban rails accounted for 57.7%, 13.0%, 7.7%, 8.6%, 1.8%, 10.5% and 0.7% of the total. Significant regional disparity was observed. The province-level per capita GHG emissions ranged from 285 kg/capita in Guizhou to 1273 kg/capita in Beijing, with national average of 486 kg/capita. Depending on province context and local policy orientation, the motorization pathways of China’s several highest motorized provinces are quite diverse. We concluded that motorization rate and transport structure were the substantial factors determining urban passenger transport associated GHG emissions. Considering the great potential of urban passenger transport growth in China, policies guiding the optimization of transport structure should be in place with priority in eastern provinces. - Highlights: • Province-leveled motorized travel, energy consumption and GHG emissions in China were studied. • Significant regional disparities on urban passenger transport were observed. • Region-specific sustainable transport energy policies were discussed

Approaching Environmental Health Disparities and Green Spaces: An Ecosystem Services Perspective

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Viniece Jennings

2015-02-01

Full Text Available Health disparities occur when adverse health conditions are unequal across populations due in part to gaps in wealth. These disparities continue to plague global health. Decades of research suggests that the natural environment can play a key role in sustaining the health of the public. However, the influence of the natural environment on health disparities is not well-articulated. Green spaces provide ecosystem services that are vital to public health. This paper discusses the link between green spaces and some of the nation’s leading health issues such as obesity, cardiovascular health, heat-related illness, and psychological health. These associations are discussed in terms of key demographic variables—race, ethnicity, and income. The authors also identify research gaps and recommendations for future research.

Unequally distributed psychological assets: are there social disparities in optimism, life satisfaction, and positive affect?

Science.gov (United States)

Boehm, Julia K; Chen, Ying; Williams, David R; Ryff, Carol; Kubzansky, Laura D

2015-01-01

Socioeconomic status is associated with health disparities, but underlying psychosocial mechanisms have not been fully identified. Dispositional optimism may be a psychosocial process linking socioeconomic status with health. We hypothesized that lower optimism would be associated with greater social disadvantage and poorer social mobility. We also investigated whether life satisfaction and positive affect showed similar patterns. Participants from the Midlife in the United States study self-reported their optimism, satisfaction, positive affect, and socioeconomic status (gender, race/ethnicity, education, occupational class and prestige, income). Social disparities in optimism were evident. Optimistic individuals tended to be white and highly educated, had an educated parent, belonged to higher occupational classes with more prestige, and had higher incomes. Findings were generally similar for satisfaction, but not positive affect. Greater optimism and satisfaction were also associated with educational achievement across generations. Optimism and life satisfaction are consistently linked with socioeconomic advantage and may be one conduit by which social disparities influence health.

Reduction of regional disparities in electric power prices by spatially effective measures and planning in the Federal Republic of Germany

Energy Technology Data Exchange (ETDEWEB)

Wagner, G

1984-01-01

For a long time energy policy has been trying to reduce disparities in electric power prices by administrative and financial measures alone. Governmental planning was opening up new prospects when long-range fuel transport - and in particular the transport of hard coal by ship or by rail - was seeing a drop in prices in the mid seventies. Since fuel transport has been lower-priced than the transport of equivalent quantities of electric power, regional disparities in electric power prices which are due to the respective supply structures may be levelled by way of power plant site selection and power plant installation according to the specific regional loads. A decentralized expansion of power generation within reach of the consumer requires but a minimum of wiring. Structural price disparities are reduced in particular in regions importing electric power at excessive prices. In addition, costs may be saved by rational energy utilization consisting above all in the application of dual-purpose power plants and by the rationalization of network infrastuctures. The study abstracted is part of a research project of the Federal Research Institute for Land Studies and Planning. The project is dealing with concepts of decentralized electric power supply and space heating. It adds to already existing related studies which deal above all with the basic problems of scheduling and planning the contents and inner structure of decentralized energy concepts.

Income Inequality and Its Consequences for Life Satisfaction: What Role Do Social Cognitions Play?

Science.gov (United States)

Schneider, Simone M.

2012-01-01

While it is generally agreed that income inequality affects an individual's well-being, researchers disagree on whether people living in areas of high income disparity report more or less happiness than those in more equal environments, thereby indicating the need to study how and why income inequality matters to the individual's well-being.…

Regional disparities, absorption capacity and Structural Fund payments: A case study of the Czech Republic

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Novosák Jiří

2017-12-01

Full Text Available The intention of this paper is to provide empirical evidence on how the factors of socio-economic disadvantage and absorption capacity influence the spatial distribution of Structural Fund (SF payments among the Czech Republic’s micro-regions during the 2007–2013 programming period. The empirical results indicate that agglomeration economies, innovation and entrepreneurship are associated with higher SF absorption capacity and higher SF payments, challenging the tendency for socio-economically disadvantaged regions to converge. SF absorption capacity measured especially by the number of project applications submitted for SF financing and by the average SF budget per project application, is a crucial concept in order to understand the relationship between within-country regional disparities and SF interventions.

Weight-Related Behaviors When Children Are in School versus on Summer Breaks: Does Income Matter?

Science.gov (United States)

Wang, Y. Claire; Vine, Seanna; Hsiao, Amber; Rundle, Andrew; Goldsmith, Jeff

2015-01-01

Background: Income disparities in US youth in academic achievement appear to widen during the summer because of discontinued learning among children from lower-income households. Little is known about whether behavioral risk factors for childhood obesity, such as diet and physical activity, also demonstrate a widening difference by income when…

The Dynamic Effects of Entrepreneurship on Regional Economic Growth

DEFF Research Database (Denmark)

Matejovsky, Lukas; Mohapatra, Sandeep; Steiner, Bodo

2014-01-01

This study explores the temporal pattern of income disparity for Canadian provinces in two estimation steps. First, an econometric growth regression model is applied to identify the impact of entrepreneurship on regional economic growth. The estimation results suggest that entrepreneurship......, measured in terms of the selfemployment rate, plays a pivotal role in determining regional development in Canada. Second, a dynamic vector autoregression (VAR) model is employed to predict the long-run regional growth effects that result from policy shocks affecting entrepreneurship. Compared to other...... growth drivers, entrepreneurship is found to have more pronounced and long-term stimulative effects on regional development for the period of 1987 to 2007...

Income distribution impacts of changes in Western Area Power Administration electricity prices. Final report

Energy Technology Data Exchange (ETDEWEB)

Rose, A.; Frias, O. [Pennsylvania State Univ., University Park, PA (United States). Dept. of Mineral Economics

1993-06-01

The purpose of this report is to present the methodology and results of an analysis of income distribution impacts associated with changes in the Western Area Power Administration (WAPA) marketing program. The focus will be on the distribution of personal income across eleven brackets in each of nine sub-regions of the WAPA market area. Moreover, these results will be translated into an assessment of the number of people who stand to gain or lose as a result of the policies and the size of these income changes. Most economic impact analyses are performed at an aggregate level. The results are typically presented in terms of net benefits, or a listing of changes in employment, output, income, or prices. What is neglected is the distribution of impacts across the affected population. These distributional impacts are important for several reasons. First, there is the normative judgmental issue of distributional justice, or equity. This addresses concerns about income disparities in general, or whether the poor, or any other group, are shouldering a disproportionate share of any burden or are failing to share significantly in any gain.

Effect of NAFTA on Mexico's Income Distribution in the Presence of Migration

OpenAIRE

Garduno-Rivera, Rafael

2010-01-01

This paper asks how NAFTA affected income distribution within Mexico considering changes in internal migration. Trade liberalization should theoretically increase the income of low-skilled workers in low-skilled labor-abundant developing countries. Thus, by increasing the wages of poorer workers, one might expect that trade will decrease income disparity. However, anecdotal evidence indicates that NAFTA increased the gap between rich and poor in Mexico. Understanding the distributional effect...

Cardiovascular disease mortality in the Americas: current trends and disparities.

Science.gov (United States)

de Fatima Marinho de Souza, Maria; Gawryszewski, Vilma Pinheiro; Orduñez, Pedro; Sanhueza, Antonio; Espinal, Marcos A

2012-08-01

To describe the current situation and trends in mortality due to cardiovascular disease (CVD) in the Americas and explore their association with economic indicators. This time series study analysed mortality data from 21 countries in the region of the Americas from 2000 to the latest available year. Age-adjusted death rates, annual variation in death rates. Regression analysis was used to estimate the annual variation and the association between age-adjusted rates and country income. Currently, CVD comprised 33.7% of all deaths in the Americas. Rates were higher in Guyana (292/100 000), Trinidad and Tobago (289/100 000) and Venezuela (246/100 000), and lower in Canada (108/100 000), Puerto Rico (121/100 000) and Chile (125/100 000). Male rates were higher than female rates in all countries. The trend analysis showed that CVD death rates in the Americas declined -19% overall (-20% among women and -18% among men). Most countries had a significant annual decline, except Guatemala, Guyana, Suriname, Paraguay and Panama. The largest annual declines were observed in Canada (-4.8%), the USA (-3.9%) and Puerto Rico (-3.6%). Minor declines were in Mexico (-0.8%) and Cuba (-1.1%). Compared with high-income countries the difference between the median of death rates in lower middle-income countries was 56.7% higher and between upper middle-income countries was 20.6% higher. CVD death rates have been decreasing in most countries in the Americas. Considerable disparities still remain in the current rates and trends.

Premature mortality in Belgium in 1993-2009: leading causes, regional disparities and 15 years change.

Science.gov (United States)

Renard, Françoise; Tafforeau, Jean; Deboosere, Patrick

2014-01-01

Reducing premature mortality is a crucial public health objective. After a long gap in the publication of Belgian mortality statistics, this paper presents the leading causes and the regional disparities in premature mortality in 2008-2009 and the changes since 1993. All deaths occurring in the periods 1993-1999 and 2003-2009, in people aged 1-74 residing in Belgium were included. The cause of death and population data for Belgium were provided by Statistics Belgium , while data for international comparisons were extracted from the WHO mortality database. Age-adjusted mortality rates and Person Year of Life Lost (PYLL) were calculated. The Rate Ratios were computed for regional and international comparisons, using the region or country with the lowest rate as reference; statistical significance was tested assuming a Poisson distribution of the number of deaths. The burden of premature mortality is much higher in men than in women (respectively 42% and 24% of the total number of deaths). The 2008-9 burden of premature mortality in Belgium reaches 6410 and 3440 PYLL per 100,000, respectively in males and females, ranking 4th and 3rd worst within the EU15. The disparities between Belgian regions are substantial: for overall premature mortality, respective excess of 40% and 20% among males, 30% and 20% among females are observed in Wallonia and Brussels as compared to Flanders. Also in cause specific mortality, Wallonia experiences a clear disadvantage compared to Flanders. Brussels shows an intermediate level for natural causes, but ranks differently for external causes, with less road accidents and suicide and more non-transport accidents than in the other regions. Age-adjusted premature mortality rates decreased by 29% among men and by 22% among women over a period of 15 years. Among men, circulatory diseases death rates decreased the fastest (-43.4%), followed by the neoplasms (-26.6%), the other natural causes (-21.0%) and the external causes (-20.8%). The larger

Inequality of Income Distribution and Economics Growth in the Regions of Russia in the Post-Crisis Period

Directory of Open Access Journals (Sweden)

Ruslan Arkadyevich Grigoryev

2015-09-01

Full Text Available Income distribution is one of the factors influencing economic growth. At present time, the regional aspect of such influence is an important sphere of research. The present article is intended to view the aspects of the influence of income distribution differentiation on economic growth on the example of the Russian regions in post-crisis period. The research results are presented in the form of regression model, estimating the differences in the growth rates of gross regional products in Russia in post-crisis 2010. The explanatory variables are Gini coefficients as an indicator of income inequality, and a number of other indicators characterizing the regional development in 2006 — 2010. Special attention is paid to the influence of 2008 crisis on the differences of regions by the level of dependent variable. Cross-sectional regression model based on the Russian Federation regions data shows the positive influence of changes in income distribution on the rate of economic growth. The general result of the research is confirmation of the hypothesis of the influence of income inequality on economic growth at the regional level in Russia. The observed effect is positive and statistically significant. The effect is relatively short-term, both from the point of view of the dependent variable (the yearly growth rate of GRP is used in the model, and from the point of view of the time lag between the year of dependent variable observation, 2010, and the period of observation, for which the Gini coefficient is significant in regression equation (2006-2007. Pre-crisis value of the Gini coefficient does not determined the differences in economic growth in the regions of Russia in 2011-2012. The results can be used in predicting the pace of regional development in Russia in the post-crisis period, as well as in the implementation of regional economic policy in times of crisis in order to maximize regional economic growth after the crisis

Infrastructure development, income inequality, and urban sustainability in the People's Republic of China

OpenAIRE

Mendoza, Octasiano M. Valerio

2017-01-01

This paper examines the relationship between infrastructure development and income inequality in urban People's Republic of China. Recent policies target reductions in income inequality while increasing sustainable urban development. Infrastructure investment plays a key role in achieving both goals, yet the effects of different infrastructures on income disparities at the city level remain undetermined. Using 10 city-level infrastructure indicators relating to sustainable urban development a...

DYNAMICS ECONOMIC DISPARITIES IN NORTH-WEST REGION OF ROMANIA

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Florea Adrian

2011-07-01

Full Text Available Even though over the years has enjoyed wide media coverage, with highlighted aspects, discrepancies and inequalities of economic potential between different regions of the world, or even parts of the same countries always remained topical. Difficulties arising from these differences were always felt, extremely painful by humans. Analyzing distinctly, participation of each county to the GDP of the Northwest Region and the composition of all indicators, we can identify significant discrepancies between counties, regions and municipalities. This is one of the reasons that led us trying to identify the causes that generated the current situation. From the perspective of the contribution of each county in the Northwest Region to Region's domestic product composition, the first place is taken by Cluj county 32.3%, followed by Bihor with 24.3%, Maramures, with 14.9% Satu-Mare, 12.1%, Bistrita-Nasaud, 9.1% and 7.2% Salaj. Consulting of the Regional Operational Programme 2007-2013 indicates that the poorest areas in the Northwest Region are in Maramures and Bistrita-Nasaud. An important part of the active population of North-West Region was employed in public enterprises and an increase of unemployment in the counties of Salaj, Satu Mare and Maramures became predictable, imminent amid restructuring of public enterprises with losses. Studies of employed population by sectors of the economy, shows a high rate of population employed in services in the counties of Cluj and Bihor and high employment in agriculture on other four counties. In a modern market economy, services are most concentrated labors, and how the workforce is distributed in the Northwest region also shows an imbalance. How Northwest Region is participating in international economic cycle has major effects on the population's living standards. Relevant for the inter-district disparities analysis is the human and agents behavior analysis and the savings and loan relationships. How people

National income inequality and self-rated health : The differing impact of individual social trust across 89 countries

NARCIS (Netherlands)

Rözer, J.; Kraaykamp, G.; Huijts, T.

2016-01-01

The well-known Income Inequality Hypothesis suggests that income disparities in a country are detrimental for people's health. Empirical studies testing this hypothesis so far have found mixed results. In this study, we argue that a reason for these mixed findings may be that high national income

National income inequality and self-rated health: The differing impact of individual social trust across 89 countries

NARCIS (Netherlands)

Rözer, J.; Kraaykamp, G.L.M.; Huijts, T.H.M.

2016-01-01

The well-known Income Inequality Hypothesis suggests that income disparities in a country are detrimental for people's health. Empirical studies testing this hypothesis so far have found mixed results. In this study, we argue that a reason for these mixed findings may be that high national income

Growing Disparities in Life Expectancy. Economic and Budget Issue Brief

Science.gov (United States)

Manchester, Joyce; Topoleski, Julie

2008-01-01

In a continuation of long-term trends, life expectancy has been steadily increasing in the United States for the past several decades. Accompanying the recent increases, however, is a growing disparity in life expectancy between individuals with high and low income and between those with more and less education. The difference in life expectancy…

Regional energy consumption and income differences in Denmark

DEFF Research Database (Denmark)

Klinge Jacobsen, Henrik

2003-01-01

income of households grouped in income deciles and by other characteristics. The impact of environmental taxes depends on income levels in rural areas compared to income in urban areas. In Denmark, the income difference is found to be quite small, but energy consumption and, therefore, also the burden......Internationally a debate on the distributional impact of energy taxation has focused on the tax burden relative to income. The general conclusion is that taxes are regressive, but at a varying degree for different countries. This study examines the relationship between location, income, heating...... technology characteristics and the energy tax that households pay. The article aims at identifying general implications of energy taxes with respect to different impacts on population groups depending on location and income. Tax payments associated with energy use are considered relative to total disposable...

The price of fixed income market volatility

CERN Document Server

Mele, Antonio

2015-01-01

Fixed income volatility and equity volatility evolve heterogeneously over time, co-moving disproportionately during periods of global imbalances and each reacting to events of different nature. While the methodology for options-based "model-free" pricing of equity volatility has been known for some time, little is known about analogous methodologies for pricing various fixed income volatilities. This book fills this gap and provides a unified evaluation framework of fixed income volatility while dealing with disparate markets such as interest-rate swaps, government bonds, time-deposits and credit. It develops model-free, forward looking indexes of fixed-income volatility that match different quoting conventions across various markets, and uncovers subtle yet important pitfalls arising from naïve superimpositions of the standard equity volatility methodology when pricing various fixed income volatilities. The ultimate goal of the authors´ efforts is to make interest rate volatility standardization a valuable...

Racial Inequality Trends and the Intergenerational Persistence of Income and Family Structure

OpenAIRE

Bloome, Deirdre

2014-01-01

Racial disparity in family incomes remained remarkably stable over the past 40 years in the United States despite major legal and social reforms. Previous scholarship presents two primary explanations for persistent inequality through a period of progressive change. One highlights continuity: because socioeconomic status is transmitted from parents to children, disparities created through histories of discrimination and opportunity denial may dissipate slowly. The second highlights change: be...

Impact of growing income inequality on sustainable development in China: a provincial-level analysis

NARCIS (Netherlands)

Heerink, N.B.M.; Ma, J.

2006-01-01

A growing body of literature has documented the rapidly increasing income disparities that accompanied China's economic growth in the 1980s and 1990s, and the driving factors behind this. Growing income inequality in its turn may have important implications for the accumulation of physical capital,

The influence of active coping and perceived stress on health disparities in a multi-ethnic low income sample

Directory of Open Access Journals (Sweden)

Tomar Scott L

2008-01-01

Full Text Available Abstract Background Extensive research has shown that ethnic health disparities are prevalent and many psychological and social factors influence health disparities. Understanding what factors influence health disparities and how to eliminate health disparities has become a major research objective. The purpose of this study was to examine the impact of coping style, stress, socioeconomic status (SES, and discrimination on health disparities in a large urban multi-ethnic sample. Methods Data from 894 participants were collected via telephone interviews. Independent variables included: coping style, SES, sex, perceived stress, and perceived discrimination. Dependent variables included self-rated general and oral health status. Data analysis included multiple linear regression modeling. Results Coping style was related to oral health for Blacks (B = .23, p Conclusion Our results indicate that perceived stress is a critical component in understanding health outcomes for all ethnoracial groups. While SES related significantly to general health for Whites and Hispanics, this relationship was mediated by perceived stress. Active coping was associated only with oral health.

[International migration and income redistribution: a trade-theoretic analysis].

Science.gov (United States)

Leiner, N; Meckl, J

1995-05-01

"We analyze the income-redistribution effects of international migration in the host and source country in a general equilibrium framework. The well-known result that marginal migration leaves the welfare of nonmigrants unaffected is discussed in more detail with regard to shifts in national income distributions. With endogenous goods' prices the consequences for the income distribution are in general ambiguous--we show possibilities for an estimation of their magnitude. As long as wage disparities determine the direction of migration it increases world efficiency. However, redistributive policies may generate migration towards the low-wage country." (SUMMARY IN ENG) excerpt

Avoiding the summer slide: can day camps close the income-education gap?

OpenAIRE

Prieur, Allison Marie

2010-01-01

Children living in poverty often experience lower educational outcomes than the general population. A cycle of poverty can result, where low education levels pass from generation to generation. Up to 65% of the disparity between lower and higher income students is attributable to the Summer Learning Loss (SLL). Low-income students generally score lower in the fall on standardized tests than they did in the spring before. In contrast, middle and higher income students maintain or increase thei...

Study and Comparison of Rural and Urban Household Income Distribution in Khorasan Province and Country during 2007-2012

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R. Jamshidi

2013-12-01

Full Text Available This study examined distrbution of household income in Khorasan Razavi province and the country for urban and rural areas, seprately. Using household income and expenditure statistics compiled by the Statistical Center of Iran during 2007-2012 the Gini index, Tile index, Atkinson index and the tenth docile to the first docile were applied.The study findings indicate that during the studied period income inequality in the country has been decreased. The levels of disparity in the urban areas have been usually higher than its levels in the country. , while the levels of disparity in the rural areas have been always lower than its levels in the country.. Morever, income distributions in the urban areas and the entire province have been always more uneven than what has been seen for the rural areas. Analysing the Tile and Atkinson indicies (ε=1 shows that both ascending and descending trends of the two indicies were consistent with the Gini index and thus, the three indicies are compatible and validate each other. On the other hand, analysing the Gross expenditures per capita for households and the Gini index shows that the levels of welfare in urban and rural areas of Khorasan were almost constant, however the index for the urban areas of the country has been decreased and for the rural areas has been increased. The social welfare often have been lower for the the rural areas than the social welfare for the urban areas. The results indicate significant differences in income distributions among the province, the country's rural areas and the urban areas.The sudy therefore proposes regional plannings to be considered.

Do gender disparities persist in gastroenterology after 10 years of practice?

Science.gov (United States)

Singh, Aparajita; Burke, Carol A; Larive, Brett; Sastri, Suriya V

2008-07-01

Cross-sectional studies confirm gender disparity in many aspects of the practice of medicine and surgery. Some data suggest the disparities diminish after 10 yr of practice. This study aims to examine gender discrepancies in income, social, and professional status of gastroenterologists after 10 yr of practice. Prospective, observational, cohort study of gastroenterologists incepted upon graduation from a U.S. GI fellowship program in 1993 and 1995. A 36-item questionnaire was sent to the cohort at 3, 5, and 10 yr after graduation from GI fellowship training. The following are the results of the final, 10th year survey. A total of 168 men and 25 women (mean age 45.5 yr) responded. Men and women were equally likely to be board certified and married, however, women had fewer children. Men earned a mean annual gross income of $375,000 versus$245,000 for women (P= 0.001). After adjusting for practice setting, work hours, practice-ownership, free endoscopy center practice, and vacation time, female gastroenterologists earned $82,000 (22%) less per year than their male colleagues (95% CI $34,000-130,000, P= 0.001). Women were more frequently in academic practice (38%vs 17%), but were less likely to hold the most advanced academic positions. After 10 yr of practice, significant economic, professional, and social disparities persist between male and female gastroenterologists in this cohort. Women were more likely to practice in a setting with flexible work hours, a family leave provision, and in a practice with other women. Initiatives to equalize pay and ensure opportunities for professional advancement for women may diminish the significant practice disparities incurred by women in gastroenterology.

The role of health-related behaviors in the socioeconomic disparities in oral health.

Science.gov (United States)

Sabbah, Wael; Tsakos, Georgios; Sheiham, Aubrey; Watt, Richard G

2009-01-01

This study aimed to examine the socioeconomic disparities in health-related behaviors and to assess if behaviors eliminate socioeconomic disparities in oral health in a nationally representative sample of adult Americans. Data are from the US Third National Health and Nutrition Examination Survey (1988-1994). Behaviors were indicated by smoking, dental visits, frequency of eating fresh fruits and vegetables and extent of calculus, used as a marker for oral hygiene. Oral health outcomes were gingival bleeding, loss of periodontal attachment, tooth loss and perceived oral health. Education and income indicated socioeconomic position. Sex, age, ethnicity, dental insurance and diabetes were adjusted for in the regression analysis. Regression analysis was used to assess socioeconomic disparities in behaviors. Regression models adjusting and not adjusting for behaviors were compared to assess the change in socioeconomic disparities in oral health. The results showed clear socioeconomic disparities in all behaviors. After adjusting for behaviors, the association between oral health and socioeconomic indicators attenuated but did not disappear. These findings imply that improvement in health-related behaviors may lessen, but not eliminate socioeconomic disparities in oral health, and suggest the presence of more complex determinants of these disparities which should be addressed by oral health preventive policies.

Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality.

Science.gov (United States)

Ponce, Ninez A; Ko, Michelle; Liang, Su-Ying; Armstrong, Joanne; Toscano, Michele; Chanfreau-Coffinier, Catherine; Haas, Jennifer S

2015-04-01

With the Affordable Care Act reducing coverage disparities, social factors could prominently determine where and for whom innovations first diffuse in health care markets. Gene expression profiling is a potentially cost-effective innovation that guides chemotherapy decisions in early-stage breast cancer, but adoption has been uneven across the United States. Using a sample of commercially insured women, we evaluated whether income inequality in metropolitan areas was associated with receipt of gene expression profiling during its initial diffusion in 2006-07. In areas with high income inequality, gene expression profiling receipt was higher than elsewhere, but it was associated with a 10.6-percentage-point gap between high- and low-income women. In areas with low rates of income inequality, gene expression profiling receipt was lower, with no significant differences by income. Even among insured women, income inequality may indirectly shape diffusion of gene expression profiling, with benefits accruing to the highest-income patients in the most unequal places. Policies reducing gene expression profiling disparities should address low-inequality areas and, in unequal places, practice settings serving low-income patients. Project HOPE—The People-to-People Health Foundation, Inc.

Trends in Income-Related Gaps in Enrollment in Early Childhood Education: 1968 to 2013

Science.gov (United States)

Magnuson, Katherine; Waldfogel, Jane

2016-01-01

The academic achievement gap between children from the lowest- and highest-income families appears to have risen in recent decades in the United States. Such income-related disparities in academic skills are already present when children enter elementary school, suggesting that the explanation for changing gaps can be traced to changing…

How Resource Dynamics Explain Accumulating Developmental and Health Disparities for Teen Parents’ Children

Science.gov (United States)

Mollborn, Stefanie; Lawrence, Elizabeth; James-Hawkins, Laurie; Fomby, Paula

2014-01-01

This study examines the puzzle of disparities experienced by U.S. teen parents’ young children, whose health and development increasingly lag behind those of peers while their parents are simultaneously experiencing socioeconomic improvements. Using the nationally representative Early Childhood Longitudinal Study-Birth Cohort (2001–2007; N ≈ 8,600), we assess four dynamic patterns in socioeconomic resources that might account for these growing developmental and health disparities throughout early childhood and then test them in multilevel growth curve models. Persistently low socioeconomic resources constituted the strongest explanation, given that consistently low income, maternal education, and assets fully or partially account for growth in cognitive, behavioral, and health disparities experienced by teen parents’ children from infancy through kindergarten. That is, although teen parents gained socioeconomic resources over time, those resources remained relatively low, and the duration of exposure to limited resources explains observed growing disparities. Results suggest that policy interventions addressing the time dynamics of low socioeconomic resources in a household, in terms of both duration and developmental timing, are promising for reducing disparities experienced by teen parents’ children. PMID:24802282

GHG emissions from primary aluminum production in China: Regional disparity and policy implications

International Nuclear Information System (INIS)

Hao, Han; Geng, Yong; Hang, Wen

2016-01-01

Highlights: • GHG emissions from primary aluminum production in China were accounted. • The impact of regional disparity of power generation was considered for this study. • GHG emissions factor of China’s primary aluminum production was 16.5 t CO_2e/t Al ingot in 2013. • Total GHG emissions from China’s primary aluminum production were 421 mt CO_2e in 2013. - Abstract: China is the world-leading primary aluminum production country, which contributed to over half of global production in 2014. Primary aluminum production is power-intensive, for which power generation has substantial impact on overall Greenhouse Gas (GHG) emissions. In this study, we explore the impact of regional disparity of China’s power generation system on GHG emissions for the sector of primary aluminum production. Our analysis reveals that the national GHG emissions factor (GEF) of China’s primary aluminum production was 16.5 t CO_2e/t Al ingot in 2013, with province-level GEFs ranging from 8.2 to 21.7 t CO_2e/t Al ingot. There is a high coincidence of provinces with high aluminum productions and high GEFs. Total GHG emissions from China’s primary aluminum production were 421 mt CO_2e in 2013, approximately accounting for 4% of China’s total GHG emissions. Under the 2020 scenario, GEF shows a 13.2% reduction compared to the 2013 level, but total GHG emissions will increase to 551 mt CO_2e. Based on our analysis, we recommend that the government should further promote energy efficiency improvement, facilitate aluminum industry redistribution with low-carbon consideration, promote secondary aluminum production, and improve aluminum industry data reporting and disclosure.

Racial Inequality Trends and the Intergenerational Persistence of Income and Family Structure

Science.gov (United States)

Bloome, Deirdre

2015-01-01

Racial disparity in family incomes remained remarkably stable over the past 40 years in the United States despite major legal and social reforms. Previous scholarship presents two primary explanations for persistent inequality through a period of progressive change. One highlights continuity: because socioeconomic status is transmitted from parents to children, disparities created through histories of discrimination and opportunity denial may dissipate slowly. The second highlights change: because family income results from joining individual earnings in family units, changing family compositions can offset individuals’ changing economic chances. I examine whether black-white family income inequality trends are better characterized by the persistence of existing disadvantage (continuity) or shifting forms of disadvantage (change). I combine cross-sectional and panel analysis using Current Population Survey, Panel Study of Income Dynamics, Census, and National Vital Statistics data. Results suggest that African Americans experience relatively extreme intergenerational continuity (low upward mobility) and discontinuity (high downward mobility); both helped maintain racial inequality. Yet, intergenerational discontinuities allow new forms of disadvantage to emerge. On net, racial inequality trends are better characterized by changing forms of disadvantage than by continuity. Economic trends were equalizing but demographic trends were disequalizing; as family structures shifted, family incomes did not fully reflect labor-market gains. PMID:26456973

REGIONAL ECONOMIC GROWTH THROUGH TOURISM. THE CASE OF REGION WEST

Directory of Open Access Journals (Sweden)

Dragoi Ionut

2010-12-01

Full Text Available The regional development should aim to correlate and integrate tourism among the other integrative parts of the regional and local development, taking into account the fact that a region’s prosperity as effect of tourism development may be shown clearly in several stages: on the spot (as a result of direct consumption of the tourist product, on short term (through continuous absorption of the work-force and encouraging the welcoming commerce and in the long run (concentrating capital for investment in the general infrastructure and the one of tourism, in structures of reception for tourism and in the development of urban services. The analysis of intra-regional disparities as part of the economic growth at the level of Region West starts off with the idea that each component county has a different landscape, which favored or inhibited their economic growth; in the same time, each component county has its own specific, which can be promoted through tourism, inducing in time a regional income, and respectively, a social-economic and cultural growth of less developed areas.

Social Disparities in Exposure to Point-of-Sale Cigarette Marketing.

Science.gov (United States)

Siahpush, Mohammad; Farazi, Paraskevi A; Kim, Jungyoon; Michaud, Tzeyu L; Yoder, Aaron M; Soliman, Ghada; Tibbits, Melissa K; Nguyen, Minh N; Shaikh, Raees A

2016-12-21

While most ecological studies have shown that higher levels of point-of-sale (POS) cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette marketing among smokers in the United States. Our aim was to examine these disparities in a Midwestern metropolitan area in the United States. We conducted a telephone survey to collect data on 999 smokers. Cigarette marketing was measured by asking respondents three questions about noticing advertisements, promotions, and displays of cigarettes within their respective neighborhoods. The questions were combined to create a summated scale. We estimated ordered logistic regression models to examine the association of sociodemographic variables with exposure to POS cigarette marketing. Adjusted results showed that having a lower income ( p marketing. The results highlight social disparities in exposure to POS cigarette marketing in the United States, which can potentially be eliminated by banning all forms of cigarette marketing.

Effect of Tariff Liberalization on Mexico’s Income Distribution in the presence of Migration

OpenAIRE

Garduno-Rivera, Rafael; Baylis, Katherine R.

2012-01-01

This paper studies how the North American Free Trade Agreement (NAFTA) affected income distribution within Mexico given internal migration. In low-skilled labor-abundant developing countries, trade liberalization should theoretically increase the income of low-skilled workers, decreasing income disparity. However, anecdotal evidence indicates that NAFTA increased the gap between rich and poor in Mexico, and empirical evidence is mixed (Chiquiar, 2005; Nicita, 2009; Hanson, 2007). Because trad...

Magnitude of income-related disparities in adverse perinatal outcomes

OpenAIRE

Shankardass, Ketan; O’Campo, Patricia; Dodds, Linda; Fahey, John; Joseph, KS; Morinis, Julia; Allen, Victoria M

2014-01-01

Background To assess and compare multiple measurements of socioeconomic position (SEP) in order to determine the relationship with adverse perinatal outcomes across various contexts. Methods A birth registry, the Nova Scotia Atlee Perinatal Database, was confidentially linked to income tax and related information for the year in which delivery occurred. Multiple logistic regression was used to examine odds ratios between multiple indicators of SEP and multiple adverse perinatal outcomes in 11...

Employment and Regional Inequality in Romania

Directory of Open Access Journals (Sweden)

Laura Patache

2013-08-01

Full Text Available It is no doubt that thinking about inequality plays a part in the judgments and actions of politicians, sociologists, economists and ordinary people, too. This paper examines which factors substantially influenced regional employment. Labour market, employment and unemployment have been the subject of various researches and the labour market object has been subject of dispute. Employment and unemployment are both decomposed and analyzed through separate components (such as: full employment, effective employment, atypical employment, precarious employment, regional/local employment etc., respectively, total unemployment, partial or hidden unemployment, technical and structural one and so on. The specific literature about the regional inequalities considered the income per capita as the most relevant indicator measured by Gini coefficient. Gini index measures the extent to which the distribution of income or consumption expenditure among individuals or households within an economy deviates from a perfectly equal distribution. At regional level we studied several indicators that generate regional disparities, and influence employment quality such us: employment rate, tertiary and medium employment, unemployment rate, occupied population in informal sector, employment in primary sector, rural employment, female employment. We developed a scoring based on the deviation from the average of a group of key indicators and devised a map of employment quality resulting from multi-criteria analysis.

Disparities in Receipt of FOBT versus Endoscopy among Filipino American Immigrants

Science.gov (United States)

Maxwell, Annette E.; Danao, Leda L.; Crespi, Catherine M.; Antonio, Cynthia; Garcia, Gabriel M.; Bastani, Roshan

2009-01-01

Background This report examines disparities associated with the type of colorectal screening test, fecal occult blood test (FOBT) versus endoscopy, within a particular racial/ethnic group, Filipino American immigrants. Methods Between July 2005 and October 2006, Filipino Americans age 50-75 from 31 community organizations in Los Angeles completed a 15-minute survey in English (65%) or Filipino (35%). Results Of the 487 respondents included in this analysis, 257 (53%) had never received any type of colorectal cancer (CRC) screening. Among the 230 subjects who had ever received a routine screening test, 78 had FOBT only (16% of the total sample) and 152 had endoscopy with or without FOBT (31% of the total sample). After controlling for access to care and key demographic variables in a multivariate analysis, only two characteristics distinguished between respondents who had FOBT only versus those who had endoscopy: acculturation, assessed by percent lifetime in the U.S. and language of interview, and income. Conclusions Our data suggest a two tier system, FOBT for less acculturated Filipino Americans with lower income versus endoscopy for Filipino immigrants with higher levels of acculturation and income. The disparity persists after adjusting for access to care. Instead of treating minority groups as monolithic, differences within groups need to be examined so that interventions can be appropriately targeted. PMID:18708385

Reducing income disparity for stability and development Malaysia's experience

OpenAIRE

Mohammad, Kamaruddin bin

2002-01-01

Approved for public release; distribution is unlimited Malaysia, a plural nation comprising of the indigenous Malays (Bumiputeras), and the immigrant Chinese and Indians has embarked on a unique program called the "New Economic Policy" (NEP) to ensure a fairer share of wealth, income, prosperity and opportunities between the ethnic groups. The NEP aimed to promote national unity by pursuing the twin objectives of the eradication of poverty and the restructuring of society to eliminate iden...

Province-Level Income Inequality and Health Outcomes in Canadian Adolescents

Science.gov (United States)

McGrath, Jennifer J.

2015-01-01

Objective To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Methods Participants (aged 12–17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Results Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Conclusions Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. PMID:25324533

Evidence for Policy Making: Health Services Access and Regional Disparities in Kerman

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Mina Anjomshoa

2013-12-01

Full Text Available Background and purpose: Health indices, regarding to their role in the development of society, are one of the most important indices at national level. Success of national development programs is largely dependent on the establishment of appropriate goals at the health sector, among which access to healthcare facilities is an essential requirement. The aim of this study was to examine the disparities in health services access across the Kerman province. Materials and Methods: This was a cross-sectional study. Study sample included the cities of Kerman province, ranked based on 15 health indices. Data was collected from statistical yearbook. The indices were weighted using Shannon entropy, then using the TOPSIS technique and the result were classified into three categories in terms of the level of development across towns. Results: The findings showed distinct regional disparities in health services across Kerman province and the significant difference was observed between the cities in terms of development. Shannon entropy introduced the number of pharmacologist per 10 thousand people as the most important indicator and the number of rural active health center per 1000 people as the less important indicator. According to TOPSIS, Kerman town (0.719 and Fahraj (0.1151 ranked the first and last in terms of access to health services respectively. Conclusion: There are significant differences between cities of Kerman province in terms of access to health care facilities and services. Therefore, it is recommended that officials and policy-makers determine resource allocation priorities according to the degree of development for a balanced and equitable distribution of health care facilities.

Educational Disparities and Conflict: Evidence from Lebanon

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Tfaily, Rania; Diab, Hassan; Kulczycki, Andrzej

2013-01-01

This article examines the impact of Lebanon's civil war (1975-1991) on disparities in education among the country's main religious sects and across various regions. District of registration is adopted as a proxy for religious affiliation through a novel, detailed classification to assess sectarian differentials by region and regional differentials…

Regional disparity and cost-effective SO2 pollution control in China: A case study in 5 mega-cities

International Nuclear Information System (INIS)

Kanada, Momoe; Dong, Liang; Fujita, Tsuyoshi; Fujii, Minoru; Inoue, Tsuyoshi; Hirano, Yujiro; Togawa, Takuya; Geng, Yong

2013-01-01

With rapid development, increasing sulfur dioxide (SO 2 ) emission becomes a key environmental issue in China. To respond to this challenge, the Chinese government established a top-down scheme to reduce its SO 2 emissions. However, regional disparity and the associated cost differences brought uncertainties to the policy effectiveness and efficiency. Few studies focus on this field. Therefore, this study tries to fill such a gap by investigating the differences of SO 2 emissions, reduction potential, and cost-effectiveness through use of the GAINS-China model in five mega-cities in China, namely, Beijing, Shanghai, Tianjin, Chongqing, and Hong Kong. A scenario analysis approach is employed, focusing on two technologies named flue gas desulfurization (FGD) and limestone injection (LINJ). Results demonstrated that a large SO 2 reduction potential exists, as well as a great disparity, among the five mega-cities. Chongqing had the largest reduction potential with lowest unit cost, while Beijng and Hong Kong showed the lowest reduction potential with higher unit cost. In Beijing and Shanghai, FGD and LINJ in the power generation sector had the larger reduction potential with the highest cost-effectiveness. However, in Chongqing, the industry sectors also had large reduction potentials. Finally, appropriate SO 2 control strategies and policies are raised by considering the local realities. - Highlights: • The cost-effectiveness of SO 2 control policy was analyzed in five mega-cities in China. • Reduction potential and cost-effectiveness were closely linked to regional disparity. • Beijing and Hong Kong showed lower reduction potential and higher marginal reduction cost. • Chongqing showed the largest reduction potential and the lowest marginal reduction cost

Mapping and benchmarking regional disparities in China’s energy supply, transformation, and end-use in 2010

DEFF Research Database (Denmark)

Mischke, Peggy; Xiong, Weiming

2015-01-01

-regions of China in 2010, benchmarks those to the corresponding national Sankey diagram, and quantifies the following major regional disparities: (i) West- and Central-China account for about 89% of the country’s coal production. (ii) About 50% of coal fired power generation and about 90% of refining can be mapped...... to East- China. (iii) East-China also dominated the country’s industrial energy consumption, accounting for about 70% of oil, about 58% of coal and about 53% of electricity consumption in industry. This paper highlights the need to combine national and regional energy planning to account for this spatial...... heterogeneity in China’s energy infrastructure, such as future energy intensity and CO2 emission reduction targets. More comparable statistical research is needed to better understand inconsistencies between China’s provincial and national energy statistics, in particular for coal. We find data differences...

Income Inequality, Economic Growth and Stroke Mortality in Brazil: Longitudinal and Regional Analysis 2002-2009.

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Natalia Vincens

Full Text Available Stroke accounts for more than 10% of all deaths globally and most of it occurs in low- and middle-income countries (LMIC. Income inequality and gross domestic product (GDP per capita has been associated to stroke mortality in developed countries. In LMIC, GDP per capita is considered to be a more relevant health determinant than income inequality. This study aims to investigate if income inequality is associated to stroke mortality in Brazil at large, but also on regional and state levels, and whether GDP per capita modulates the impact of this association.Stroke mortality rates, Gini index and GDP per capita data were pooled for the 2002 to 2009 period from public available databases. Random effects models were fitted, controlling for GDP per capita and other covariates.Income inequality was independently associated to stroke mortality rates, even after controlling for GDP per capita and other covariates. GDP per capita reduced only partially the impact of income inequality on stroke mortality. A decrease in 10 points in the Gini index was associated with 18% decrease in the stroke mortality rate in Brazil.Income inequality was independently associated to stroke mortality in Brazil.

Income Inequality, Economic Growth and Stroke Mortality in Brazil: Longitudinal and Regional Analysis 2002-2009.

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Vincens, Natalia; Stafström, Martin

2015-01-01

Stroke accounts for more than 10% of all deaths globally and most of it occurs in low- and middle-income countries (LMIC). Income inequality and gross domestic product (GDP) per capita has been associated to stroke mortality in developed countries. In LMIC, GDP per capita is considered to be a more relevant health determinant than income inequality. This study aims to investigate if income inequality is associated to stroke mortality in Brazil at large, but also on regional and state levels, and whether GDP per capita modulates the impact of this association. Stroke mortality rates, Gini index and GDP per capita data were pooled for the 2002 to 2009 period from public available databases. Random effects models were fitted, controlling for GDP per capita and other covariates. Income inequality was independently associated to stroke mortality rates, even after controlling for GDP per capita and other covariates. GDP per capita reduced only partially the impact of income inequality on stroke mortality. A decrease in 10 points in the Gini index was associated with 18% decrease in the stroke mortality rate in Brazil. Income inequality was independently associated to stroke mortality in Brazil.

Ethnic disparity in severe acute maternal morbidity: A nationwide cohort study in the Netherlands

NARCIS (Netherlands)

Zwart, J.J.; Jonkers, M.D.; Richters, A.; Öry, F.; Bloemenkamp, K.W.; Duvekot, J.J.; Roosmalen, J. van

2011-01-01

Background: There are concerns about ethnic disparity in outcome of obstetric health care in high-income countries. Our aim was to assess these differences in a large cohort of women having experienced severe acute maternal morbidity (SAMM) during pregnancy, delivery and puerperium. Methods: All

Ethnic disparity in severe acute maternal morbidity: a nationwide cohort study in the Netherlands

NARCIS (Netherlands)

Zwart, J.J.; Jonkers, M.D.; Richters, A.; Öry, F.; Bloemenkamp, K.W.; Duvekot, J.J.; van Roosmalen, J.

2011-01-01

Background: There are concerns about ethnic disparity in outcome of obstetric health care in high-income countries. Our aim was to assess these differences in a large cohort of women having experienced severe acute maternal morbidity (SAMM) during pregnancy, delivery and puerperium. Methods: All

Implementing the Institute of Medicine definition of disparities: an application to mental health care.

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McGuire, Thomas G; Alegria, Margarita; Cook, Benjamin L; Wells, Kenneth B; Zaslavsky, Alan M

2006-10-01

In a recent report, the Institute of Medicine (IOM) defines a health service disparity between population groups to be the difference in treatment or access not justified by the differences in health status or preferences of the groups. This paper proposes an implementation of this definition, and applies it to disparities in outpatient mental health care. Health Care for Communities (HCC) reinterviewed 9,585 respondents from the Community Tracking Study in 1997-1998, oversampling individuals with psychological distress, alcohol abuse, drug abuse, or mental health treatment. The HCC is designed to make national estimates of service use. Expenditures are modeled using generalized linear models with a log link for quantity and a probit model for any utilization. We adjust for group differences in health status by transforming the entire distribution of health status for minority populations to approximate the white distribution. We compare disparities according to the IOM definition to other methods commonly used to assess health services disparities. Our method finds significant service disparities between whites and both blacks and Latinos. Estimated disparities from this method exceed those for competing approaches, because of the inclusion of effects of mediating factors (such as income) in the IOM approach. A rigorous definition of disparities is needed to monitor progress against disparities and to compare their magnitude across studies. With such a definition, disparities can be estimated by adjusting for group differences in models for expenditures and access to mental health services.

The evaluation of the trends of Polish farms incomes in the FADN regions after the integration with the EU

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Aleksander Grzelak

2011-01-01

Full Text Available The main aim of this article was to identify trends regarding income changes in the period of 2004-2008 in Poland between the regions of FADN. In 2004-2008 we noticed the processes of convergence in range of income situation of farms among the FADN regions. It was noticed that the convergence of beta type and the sigma were in place. This situation appears for general group of farms, as well as in farms with mixed production. Although, exclusion of the subsidies would initiate the divergence processes. This means that direct payments make up a kind of catalytic situation in range of levelling incomes situation in farms among these regions. We could initially signal that instruments of the CAP favour getting differences of incomes smaller in spatial range, what would indicate some kind of strategy in the aims of the EU policy with reference to sustainable growth in spatial range.

Socioeconomic disparities in health in the US: an agenda for action.

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Moss, N

2000-12-01

Inequality of income and wealth in the US has been growing rapidly since 1972. Evidence of socioeconomic effects on health is documented for many endpoints, and there is evidence that socioeconomic disparities in health are increasing. In Europe, equity in health and health care is a target of the World Health Organization, and has led to a variety of activities to reduce socioeconomic disparities in morbidity and mortality. In the US, activities in the public and private sectors have increased in recent years but attention, especially among the public-at-large in addition to elites, needs to be shifted to socioeconomic disparities. The paper suggests action strategies drawn from the European experience and other US efforts to place public health priorities on the policy agenda. A first step is to create a climate of unacceptability for socioeconomic disparities in health. Recommended activities include improvement and utilization of existing data; dissemination to broad audiences; building on existing initiatives; creating multi-sectoral alliances; formation of state and community task forces; attention to human capital as well as social justice issues; creative use of media; attraction of new funders; and implementation of quantitative targets.

The effect of agricultural policy reforms on income inequality in Swiss agriculture - An analysis for valley, hill and mountain regions

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Benni, El N.; Finger, R.

2013-01-01

Using FADN data, we analyse the development of income inequality in Swiss agriculture for the valley, hill and mountain regions over the period 1990–2009. While household income inequality remained stable, farm income inequality increased during this period. Estimated Gini elasticities show that

Regional heterogeneity in consumption due to current income shocks: New evidence from the Permanent Income Hypothesis

DEFF Research Database (Denmark)

Mitze, Timo

In the light of new theoretical and empirical work on the Permanent Income Hypothesis we tackle earlier findings for German data, which reject its validity given a large fraction of liquidity constrained consumers. Starting from a standard short run approach we do not find evidence for excess...... borrow from the literature on Poolability tests and search for macro regional clusters with similar adjustment paths. The findings show that for the sample of West German states between 1970 and 2006 both for short and long run parameters the assumption of poolability of the data cannot be rejected...

Study of the factors of interregional convergence/divergence in real incomes and «social well-being» of Russian regions

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Malkina Marina, Yu.

2015-12-01

Full Text Available The purpose of this paper is the measurement of the degree of inter-regional convergence / divergence of Russian regions in per capita GRP, nominal and real incomes and social well-being index (SWI in 2004-2013, as well as the evaluation of the factors that have caused these changes. Methods: deflation of household incomes by means of relative cost of living index in the regions; measurement of social well-being, based on the index of localization of real incomes relatively intraregional Gini coefficient; calculation of weighted indices of inter-regional differentiation (Gini and variation coefficients, Hachman, Theil and Atkinson indexes; proportional method of factor analysis. Results obtained: 1 in 2004-2013 in Russia there was a convergence of all regional indicators, however, in a change of the social well-being index there are two periods of divergence: 2009 (a weak growth and 2012 (a significant burst; 2 the main factors of regions’ convergence in the SWI were: (re distribution factor (its impact over time increased significantly, inflation factor (it is observed a small reduction in its influence and the factor of intraregional income inequality (its influence is mainly depleted. The results may be useful for different levels government in the management of regional development.

Suicidal behaviour in Indigenous compared to non-Indigenous males in urban and regional Australia: Prevalence data suggest disparities increase across age groups.

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Armstrong, Gregory; Pirkis, Jane; Arabena, Kerry; Currier, Dianne; Spittal, Matthew J; Jorm, Anthony F

2017-12-01

We compare the prevalence of suicidal thoughts and attempts between Indigenous and non-Indigenous males in urban and regional Australia, and examine the extent to which any disparity between Indigenous and non-Indigenous males varies across age groups. We used data from the baseline wave of The Australian Longitudinal Study on Male Health (Ten to Men), a large-scale cohort study of Australian males aged 10-55 years residing in urban and regional areas. Indigenous identification was determined through participants self-reporting as Aboriginal, Torres Strait Islander or both. The survey collected data on suicidal thoughts in the preceding 2 weeks and lifetime suicide attempts. A total of 432 participants (2.7%) identified as Indigenous and 15,425 as non-Indigenous (97.3%). Indigenous males were twice as likely as non-Indigenous males to report recent suicidal thoughts (17.6% vs 9.4%; odds ratio = 2.1, p age groups, but a significant gap emerged among men aged 30-39 years and was largest among men aged 40-55 years. Similarly, the prevalence of lifetime suicide attempts did not differ between Indigenous and non-Indigenous males in the 14- to 17-years age group, but a disparity emerged in the 18- to 24-years age group and was even larger among males aged 25 years and older. Our paper presents unique data on suicidal thoughts and attempts among a broad age range of Indigenous and non-Indigenous males. The disparity in the prevalence of suicidal thoughts increased across age groups, which is in contrast to the large disparity between the Indigenous and non-Indigenous suicide rates in younger age groups.

Province-level income inequality and health outcomes in Canadian adolescents.

Science.gov (United States)

Quon, Elizabeth C; McGrath, Jennifer J

2015-03-01

To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Participants (aged 12-17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Factors contributing to the psychological well-being for Hong Kong Chinese children from low-income families: a qualitative study.

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Ho, Ka Yan; Li, William H C; Chung, Joyce Oi Kwan; Lam, Katherine Ka Wai; Chan, Sophia S C; Xia, Wei

2016-01-01

Despite compelling evidence demonstrating the negative impact of poverty and income disparity on children's psychological well-being, there has been a lack of qualitative information which addresses its contributing factors. This study aimed to shed light on this area by comparing the experiences toward daily life between children living in low- and high-income families. A qualitative study using a phenomenological approach was conducted from May 2012 to January 2013. A random sample of 42 children aged 10-13, with 25 from low- and 17 from high-income families were asked to voluntarily response to a demographic sheet and undergo individual semi-structured interviews which lasted about 25-30 min. Content analysis was used to analyze the data. Approval for the study was obtained from the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (reference UW 12-237). The findings of this study revealed that the living environment, physical health, social life and ability to function at school of children from low-income families are severely impaired. It fills a gap in the literature by showing how poverty and income disparity affect the daily lives of children from low-income families on different levels. Also, adopting a sedentary lifestyle and unhealthy eating habits are possible factors mediating the effects of poverty and income disparity on the psychological well-being of children from low-income families. It is vital for healthcare professionals going beyond their normal roles to give advice on healthy lifestyles and behaviors by building multidisciplinary partnerships with schools and the community. Additionally, healthcare professionals should also target on these two possible factors to develop and implement appropriate interventions for promoting the psychological well-being among children living in poverty. Trial registration NCT02877719. 19 August 2016 retrospectively registered.

Gender Disparities in Ghana National Health Insurance Claims: An Econometric Analysis

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Samuel Antwi

2014-01-01

Full Text Available The objective of this study was to find out the gender disparities in Ghana national health insurance claims. In this work, data was collected from the policyholders of the Ghana National Health Insurance Scheme with the help of the National Health Insurance database and the patients’ attendance register of the Koforidua Regional Hospital, from 1st January to 31st December 2011. The generalized linear regression (GLR models and the SPSS version 17.0 were used for the analysis. Among men, the younger people prefer attending hospital for treatment as compared to their adult counterparts. In contrast to women, younger women favor attending hospital for treatment as compared to their adult counterparts. Among men, various levels of income impact greatly on their propensity to make an insurance claim, whereas among women only the highest income level did as compared to lowest income level.Men, who completed senior high school education, were less likely to make an insurance claim as compared to their counterparts with basic or no education. However it was women who had basic education that preferred using the hospital as compared to their more educated counterparts. It is suggested that the government should consider building more health centers, clinics and cheap-compounds in at least every community, to help reduce the travel time in accessing health care.  The ministry of health and the Ghana health service should engage older citizens by encouraging them to use hospitals when they are sick instead of other alternative care providers.

Common mental disorders, neighbourhood income inequality and income deprivation: small-area multilevel analysis.

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Fone, David; Greene, Giles; Farewell, Daniel; White, James; Kelly, Mark; Dunstan, Frank

2013-04-01

Common mental disorders are more prevalent in areas of high neighbourhood socioeconomic deprivation but whether the prevalence varies with neighbourhood income inequality is not known. To investigate the hypothesis that the interaction between small-area income deprivation and income inequality was associated with individual mental health. Multilevel analysis of population data from the Welsh Health Survey, 2003/04-2010. A total of 88,623 respondents aged 18-74 years were nested within 50,587 households within 1887 lower super output areas (neighbourhoods) and 22 unitary authorities (regions), linked to the Gini coefficient (income inequality) and the per cent of households living in poverty (income deprivation). Mental health was measured using the Mental Health Inventory MHI-5 as a discrete variable and as a 'case' of common mental disorder. High neighbourhood income inequality was associated with better mental health in low-deprivation neighbourhoods after adjusting for individual and household risk factors (parameter estimate +0.70 (s.e. = 0.33), P = 0.036; odds ratio (OR) for common mental disorder case 0.92, 95% CI 0.88-0.97). Income inequality at regional level was significantly associated with poorer mental health (parameter estimate -1.35 (s.e. = 0.54), P = 0.012; OR = 1.13, 95% CI 1.04-1.22). The associations between common mental disorders, income inequality and income deprivation are complex. Income inequality at neighbourhood level is less important than income deprivation as a risk factor for common mental disorders. The adverse effect of income inequality starts to operate at the larger regional level.

Income inequality in Romania: The exponential-Pareto distribution

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Oancea, Bogdan; Andrei, Tudorel; Pirjol, Dan

2017-03-01

We present a study of the distribution of the gross personal income and income inequality in Romania, using individual tax income data, and both non-parametric and parametric methods. Comparing with official results based on household budget surveys (the Family Budgets Survey and the EU-SILC data), we find that the latter underestimate the income share of the high income region, and the overall income inequality. A parametric study shows that the income distribution is well described by an exponential distribution in the low and middle incomes region, and by a Pareto distribution in the high income region with Pareto coefficient α = 2.53. We note an anomaly in the distribution in the low incomes region (∼9,250 RON), and present a model which explains it in terms of partial income reporting.

Examination of race disparities in physical inactivity among adults of similar social context.

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Wilson-Frederick, Shondelle M; Thorpe, Roland J; Bell, Caryn N; Bleich, Sara N; Ford, Jean G; LaVeist, Thomas A

2014-01-01

The objective of the study was to determine whether race disparities in physical inactivity are present among urban low-income Blacks and Whites living in similar social context. This analysis included Black and White respondents ( > or = 18 years) from the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB; N=1350) Study and the National Health Interview Survey (NHIS; N = 67790). Respondents who reported no levels of moderate or vigorous physical activity, during leisure time, over a usual week were considered physically inactive. After controlling for confounders, Blacks had higher adjusted odds of physical inactivity compared to Whites in the national sample (odds ratio [OR] = 1.40; 95% confidence interval [CI] =1.30-1.51). In EHDIC-SWB, Blacks and Whites had a similar odds of physical inactivity (OR = 1.09; 95% CI .86-1.40). Social context contributes to our understanding of racial disparities in physical inactivity.

Do Water Rights Affect Technical Efficiency and Social Disparities of Crop Production in the Mediterranean? The Spanish Ebro Basin Evidence

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Sonia Quiroga

2014-11-01

Full Text Available The coming agenda for the European Common Agricultural Policy includes more incentives for the environmental compliance of farmer’s activities. This will be particularly important in the case of water risk management in Mediterranean countries. Among the new challenges is the need to evaluate some of the instruments necessary to comply with the Water Framework Directive requirements that emphasize the management of water demand to achieve the environmental targets. Here we analyze the implications of changing water rights as a policy response to these challenges. We analyze two important aspects of the decision: (i the effects on the crop productivity and efficiency and (ii the effects on the rural income distribution. We provide the empirical estimations for the marginal effects on the two considered aspects. First, we calculate a stochastic frontier production function for five representative crops using historical data to estimate technical efficiency. Second, we use a decomposition of the Gini coefficient to estimate the impact of irrigation rights changes on yield disparity. In our estimates, we consider both bio-physical and socio-economic aspects to conclude that there are long term implications on both efficiency and social disparities. We find disparities in the adaptation strategies depending on the crop and the region analyzed.

[Offered income, salary expectations, and the economic activity of married women: an analytic model].

Science.gov (United States)

Lollivier, S

1984-06-01

This study uses data from tax declarations for 40,000 French households for 1975 to propose a model that permits quantification of the effects of certain significant factors on the economic activity of married women. The PROBIT model of analysis of variance was used to determine the specific effect of several variables, including age of the woman, number of children under 25 years of age in the household, the age of the youngest child, husband's income and socioprofessional status, wife's level and type of education, size of community of residence and region of residence. The principal factors influencing activity rates were found to be educational level, age, and to those of childless women, but activity rates dropped by about 30% for mothers of 2 and even more for mothers of 3 or more children. Influence of the place of residence and the husband's income were associated with lesser disparities. The reasons for variations in female labor force participation can be viewed as analogous to a balance. Underlying factors can increase or decrease the income the woman hopes to earn (offered income) as well as the minimum income for which she will work (required salary). A TOBIT model was constructed in which income was a function of age, education, geographic location, and number of children, and salary required was a function of the variables related to the husband including income and socioprofessional status. For most of the effects considered, the observed variation in activity rates resulted from variations in offered income. The husband's income influences only the desired salary. The offered income decreases and the required salary increases when the number of children is 2 or more, reducing the rate of activity. More educated women have slightly greater salary expectations, but command much higher salaries, resulting in an increased rate of professional activity.

An Investigation of the Perceptions of Low-Income Students of Color Concerning College Costs and Financial Aid Information

Science.gov (United States)

Waters, Jennifer A.

2009-01-01

As college enrollments continue to increase, the disparity between middle-income white students and low-income students of color enrolling in private higher educational institutions continues to widen. Previous research has identified barriers such as access and equity in education, the high cost of education, and limited knowledge regarding…

Drinking water infrastructure and environmental disparities: evidence and methodological considerations.

Science.gov (United States)

VanDerslice, James

2011-12-01

Potable drinking water is essential to public health; however, few studies have investigated income or racial disparities in water infrastructure or drinking water quality. There were many case reports documenting a lack of piped water or serious water quality problems in low income and minority communities, including tribal lands, Alaskan Native villages, colonias along the United States-Mexico border, and small communities in agricultural areas. Only 3 studies compared the demographic characteristics of communities by the quality of their drinking water, and the results were mixed in these studies. Further assessments were hampered by difficulties linking specific water systems to the sociodemographic characteristics of communities, as well as little information about how well water systems operated and the effectiveness of governmental oversight.

Drinking Water Infrastructure and Environmental Disparities: Evidence and Methodological Considerations

Science.gov (United States)

2011-01-01

Potable drinking water is essential to public health; however, few studies have investigated income or racial disparities in water infrastructure or drinking water quality. There were many case reports documenting a lack of piped water or serious water quality problems in low income and minority communities, including tribal lands, Alaskan Native villages, colonias along the United States–Mexico border, and small communities in agricultural areas. Only 3 studies compared the demographic characteristics of communities by the quality of their drinking water, and the results were mixed in these studies. Further assessments were hampered by difficulties linking specific water systems to the sociodemographic characteristics of communities, as well as little information about how well water systems operated and the effectiveness of governmental oversight. PMID:21836110

Do socio-economic disparities in dental treatment needs exist in Lithuanian adolescents?

Science.gov (United States)

Aleksejuniene, Jolanta; Brukiene, Vilma

2008-01-01

To explore disparities in needs for dental treatment which arise from individual and area-based socio-economic determinants. A cross-sectional study conducted in 22 randomly selected Lithuanian areas. In each of the pre-selected areas, one secondary school was randomly chosen. A total of 885 15-16-year-olds participated. Outcome measures. Dental treatment need was evaluated following the WHO guidelines and aQuantitative Summative Dental Treatment Needs Index (QSDTNI) was used to calculate the total burden of needs. The information about socio-economical determinants was obtained from a structured questionnaire and national statistics database. Individual socio-economic status (SES) measures were: parents' occupation, family structure, family income and affordability to have holiday used as a proxy measure for income. The area-based SES estimates were: unemployment, average household income, educational attainment, natural increase/decrease of population in an area and net migration rate. Data was analyzed by bivariate and multivariate analyses. None of significant bivariate associations between individual socio-economic variables and the QSDTNI were detected. Among area-based variables natural increase/decrease of population in an area and net migration rate were significantly related to the QSDTNI. Two individual and two area-based factors were extracted and introduced into Linear Multiple Regression Analysis (LMR). The LMR model was significant, but only one factor, i.e. area demographics, significantly contributed to this model. There are no clear social disparities in dental treatment needs in Lithuanian adolescents.

Health disparities monitoring in the U.S.: lessons for monitoring efforts in Israel and other countries.

Science.gov (United States)

Abu-Saad, Kathleen; Avni, Shlomit; Kalter-Leibovici, Ofra

2018-02-28

Health disparities are a persistent problem in many high-income countries. Health policymakers recognize the need to develop systematic methods for documenting and tracking these disparities in order to reduce them. The experience of the U.S., which has a well-established health disparities monitoring infrastructure, provides useful insights for other countries. This article provides an in-depth review of health disparities monitoring in the U.S. Lessons of potential relevance for other countries include: 1) the integration of health disparities monitoring in population health surveillance, 2) the role of political commitment, 3) use of monitoring as a feedback loop to inform future directions, 4) use of monitoring to identify data gaps, 5) development of extensive cross-departmental cooperation, and 6) exploitation of digital tools for monitoring and reporting. Using Israel as a case in point, we provide a brief overview of the healthcare and health disparities landscape in Israel, and examine how the lessons from the U.S. experience might be applied in the Israeli context. The U.S. model of health disparities monitoring provides useful lessons for other countries with respect to documentation of health disparities and tracking of progress made towards their elimination. Given the persistence of health disparities both in the U.S. and Israel, there is a need for monitoring systems to expand beyond individual- and healthcare system-level factors, to incorporate social and environmental determinants of health as health indicators/outcomes.

Common mental disorders, neighbourhood income inequality and income deprivation: small-area multilevel analysis

Science.gov (United States)

Fone, David; Greene, Giles; Farewell, Daniel; White, James; Kelly, Mark; Dunstan, Frank

2013-01-01

Background Common mental disorders are more prevalent in areas of high neighbourhood socioeconomic deprivation but whether the prevalence varies with neighbourhood income inequality is not known. Aims To investigate the hypothesis that the interaction between small-area income deprivation and income inequality was associated with individual mental health. Method Multilevel analysis of population data from the Welsh Health Survey, 2003/04–2010. A total of 88 623 respondents aged 18–74 years were nested within 50 587 households within 1887 lower super output areas (neighbourhoods) and 22 unitary authorities (regions), linked to the Gini coefficient (income inequality) and the per cent of households living in poverty (income deprivation). Mental health was measured using the Mental Health Inventory MHI-5 as a discrete variable and as a ‘case’ of common mental disorder. Results High neighbourhood income inequality was associated with better mental health in low-deprivation neighbourhoods after adjusting for individual and household risk factors (parameter estimate +0.70 (s.e. = 0.33), P = 0.036; odds ratio (OR) for common mental disorder case 0.92, 95% CI 0.88–0.97). Income inequality at regional level was significantly associated with poorer mental health (parameter estimate -1.35 (s.e. = 0.54), P = 0.012; OR = 1.13, 95% CI 1.04–1.22). Conclusions The associations between common mental disorders, income inequality and income deprivation are complex. Income inequality at neighbourhood level is less important than income deprivation as a risk factor for common mental disorders. The adverse effect of income inequality starts to operate at the larger regional level. PMID:23470284

Choropleth map legend design for visualizing community health disparities

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Cromley Ellen K

2009-09-01

Full Text Available Abstract Background Disparities in health outcomes across communities are a central concern in public health and epidemiology. Health disparities research often links differences in health outcomes to other social factors like income. Choropleth maps of health outcome rates show the geographical distribution of health outcomes. This paper illustrates the use of cumulative frequency map legends for visualizing how the health events are distributed in relation to social characteristics of community populations. The approach uses two graphs in the cumulative frequency legend to highlight the difference between the raw count of the health events and the raw count of the social characteristic like low income in the geographical areas of the map. The approach is applied to mapping publicly available data on low birth weight by town in Connecticut and Lyme disease incidence by town in Connecticut in relation to income. The steps involved in creating these legends are described in detail so that health analysts can adopt this approach. Results The different health problems, low birth weight and Lyme disease, have different cumulative frequency signatures. Graphing poverty population on the cumulative frequency legends revealed that the poverty population is distributed differently with respect to the two different health problems mapped here. Conclusion Cumulative frequency legends can be useful supplements for choropleth maps. These legends can be constructed using readily available software. They contain all of the information found in standard choropleth map legends, and they can be used with any choropleth map classification scheme. Cumulative frequency legends effectively communicate the proportion of areas, the proportion of health events, and/or the proportion of the denominator population in which the health events occurred that falls within each class interval. They illuminate the context of disease through graphing associations with other

Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality.

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Burns, Jonathan K; Tomita, Andrew; Kapadia, Amy S

2014-03-01

Income inequality is associated with numerous negative health outcomes. There is evidence that ecological-level socio-environmental factors may increase risk for schizophrenia. The aim was to investigate whether measures of income inequality are associated with incidence of schizophrenia at the country level. We conducted a systematic review of incidence rates for schizophrenia, reported between 1975 and 2011. For each country, national measures of income inequality (Gini coefficient) along with covariate risk factors for schizophrenia were obtained. Multi-level mixed-effects Poisson regression was performed to investigate the relationship between Gini coefficients and incidence rates of schizophrenia controlling for covariates. One hundred and seven incidence rates (from 26 countries) were included. Mean incidence of schizophrenia was 18.50 per 100,000 (SD = 11.9; range = 1.7-67). There was a significant positive relationship between incidence rate of schizophrenia and Gini coefficient (β = 1.02; Z = 2.28; p = .02; 95% CI = 1.00, 1.03). Countries characterized by a large rich-poor gap may be at increased risk of schizophrenia. We suggest that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.

Voluntary income redistribution with migration.

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Crane, R

1992-01-01

This study is concerned with the welfare magnet problem, in which disparities in transfer policies across states are believed to encourage recipient and possibly resource migration. "This study clarifies the terms of the debate by showing how the value of redistributing local resources depends not only on the value of income to each group, but also on the cost of the transfer in erosion of the resource base through migration and through the general equilibrium effects of such activity on local prices." The geographical focus is on the United States. excerpt

Income and health-related quality of life among prostate cancer patients over a one-year period after radical prostatectomy: a linear mixed model analysis.

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Klein, Jens; Lüdecke, Daniel; Hofreuter-Gätgens, Kerstin; Fisch, Margit; Graefen, Markus; von dem Knesebeck, Olaf

2017-09-01

To examine income-related disparities in health-related quality of life (HRQOL) over a one-year period after surgery (radical prostatectomy) and its contributory factors in a longitudinal perspective. Evidence of associations between income and HRQOL among patients with prostate cancer (PCa) is sparse and their explanations still remain unclear. 246 males of two German hospitals filled out a questionnaire at the time of acute treatment, 6 and 12 months later. Age, partnership status, baseline disease and treatment factors, physical and psychological comorbidities, as well as treatment factors and adverse effects at follow-up were additionally included in the analyses to explain potential disparities. HRQOL was assessed with the EORTC (European Organisation for Research and Treatment of Cancer) QLQ-C30 core questionnaire and the prostate-specific QLQ-PR25. A linear mixed model for repeated measures was calculated. The fixed effects showed highly significant income-related inequalities regarding the majority of HRQOL scales. Less affluent PCa patients reported lower HRQOL in terms of global quality of life, all functional scales and urinary symptoms. After introducing relevant covariates, some associations became insignificant (physical, cognitive and sexual function), while others only showed reduced estimates (global quality of life, urinary symptoms, role, emotional and social function). In particular, mental disorders/psychological comorbidity played a relevant role in the explanation of income-related disparities. One year after surgery, income-related disparities in various dimensions of HRQOL persist. With respect to economically disadvantaged PCa patients, the findings emphasize the importance of continuous psychosocial screening and tailored interventions, of patients' empowerment and improved access to supportive care.

Social Disparities in Exposure to Point-of-Sale Cigarette Marketing

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Mohammad Siahpush

2016-12-01

Full Text Available While most ecological studies have shown that higher levels of point-of-sale (POS cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette marketing among smokers in the United States. Our aim was to examine these disparities in a Midwestern metropolitan area in the United States. We conducted a telephone survey to collect data on 999 smokers. Cigarette marketing was measured by asking respondents three questions about noticing advertisements, promotions, and displays of cigarettes within their respective neighborhoods. The questions were combined to create a summated scale. We estimated ordered logistic regression models to examine the association of sociodemographic variables with exposure to POS cigarette marketing. Adjusted results showed that having a lower income (p < 0.003 and belonging to a race/ethnicity other than “non-Hispanic White” (p = 0.011 were associated with higher levels of exposure to POS cigarette marketing. The results highlight social disparities in exposure to POS cigarette marketing in the United States, which can potentially be eliminated by banning all forms of cigarette marketing.

What determines the income gap between French male and female GPs - the role of medical practices

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Dumontet Magali

2012-09-01

Full Text Available Abstract Background In many OECD countries, the gender differences in physicians’ pay favour male doctors. Due to the feminisation of the doctor profession, it is essential to measure this income gap in the French context of Fee-for-service payment (FFS and then to precisely identify its determinants. The objective of this study is to measure and analyse the 2008 income gap between males and females general practitioners (GPs. This paper focuses on the role of gender medical practices differentials among GPs working in private practice in the southwest region of France. Methods Using data from 339 private-practice GPs, we measured an average gender income gap of approximately 26% in favour of men. Using the decomposition method, we examined the factors that could explain gender disparities in income. Results The analysis showed that 73% of the income gap can be explained by the average differences in doctors’ characteristics; for example, 61% of the gender income gap is explained by the gender differences in workload, i.e., number of consultations and visits, which is on average significantly lower for female GPs than for male GPs. Furthermore, the decomposition method allowed us to highlight the differences in the marginal returns of doctors’ characteristics and variables contributing to income, such as GP workload; we found that female GPs have a higher marginal return in terms of earnings when performing an additional medical service. Conclusions The findings of this study help to understand the determinants of the income gap between male and female GPs. Even though workload is clearly an essential determinant of income, FFS does not reduce the gender income gap, and there is an imperfect relationship between the provision of medical services and income. In the context of feminisation, it appears that female GPs receive a lower income but attain higher marginal returns when performing an additional consultation.

What determines the income gap between French male and female GPs - the role of medical practices.

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Dumontet, Magali; Le Vaillant, Marc; Franc, Carine

2012-09-21

In many OECD countries, the gender differences in physicians' pay favour male doctors. Due to the feminisation of the doctor profession, it is essential to measure this income gap in the French context of Fee-for-service payment (FFS) and then to precisely identify its determinants. The objective of this study is to measure and analyse the 2008 income gap between males and females general practitioners (GPs). This paper focuses on the role of gender medical practices differentials among GPs working in private practice in the southwest region of France. Using data from 339 private-practice GPs, we measured an average gender income gap of approximately 26% in favour of men. Using the decomposition method, we examined the factors that could explain gender disparities in income. The analysis showed that 73% of the income gap can be explained by the average differences in doctors' characteristics; for example, 61% of the gender income gap is explained by the gender differences in workload, i.e., number of consultations and visits, which is on average significantly lower for female GPs than for male GPs. Furthermore, the decomposition method allowed us to highlight the differences in the marginal returns of doctors' characteristics and variables contributing to income, such as GP workload; we found that female GPs have a higher marginal return in terms of earnings when performing an additional medical service. The findings of this study help to understand the determinants of the income gap between male and female GPs. Even though workload is clearly an essential determinant of income, FFS does not reduce the gender income gap, and there is an imperfect relationship between the provision of medical services and income. In the context of feminisation, it appears that female GPs receive a lower income but attain higher marginal returns when performing an additional consultation.

Estimating the inequality of legal and latent incomes with regard to the purchasing power of ruble in the Russian regions

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G. P. Litvintseva

2010-12-01

Full Text Available The paper presents the research results of monetary income differentiation of the population with use of the author's methodical approach with regard to different purchasing power of ruble in the Russian regions. All the population of Russia was rearranged from regional quintile groups into the all-Russian groups that resulted in significant changes of inequality parameters at the interregional level of incomes in comparison with the Rosstat parameters. For the first time an influence of latent incomes to inequality and poverty level in the Russian regions is analyzed. Division of the population of the country into needy and wealthy groups is offered. Calculations and recommendations regarding redistributive overcoming of poverty at the expense of increase of the rate of surtax on incomes of the wealthy group are developed. The models by Pen, Lorenz and Ravallion-Huppi, modified by the authors of the article, were applied in the research. Calculations were carried out for all subjects of the Russian Federation (without the Chechen republic according to the Russian State Statistics Service figures for 2000–2008.

Family Income Reduces Risk of Obesity for White but Not Black Children

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Shervin Assari

2018-06-01

Full Text Available Background: Although the protective effects of socioeconomic status (SES on obesity and cardiovascular disease are well established, these effects may differ across racial and ethnic groups. Aims: Using a national sample, this study investigated racial variation in the association between family income and childhood obesity in White and Black families. Methods: This cross-sectional study used data from the National Survey of Children’s Health (NSCH, 2003–2004, a nationally representative survey in the United States. This analysis included 76,705 children 2–17 years old who were either White (n = 67,610, 88.14% or Black (n = 9095, 11.86%. Family income to needs ratio was the independent variable. Childhood obesity was the outcome. Race was the focal moderator. Logistic regression was used for data analysis. Results: Overall, higher income to needs ratio was protective against childhood obesity. Race, however, interacted with income to needs ratio on odds of childhood obesity, indicating smaller effects for Black compared to White families. Race stratified logistic regressions showed an association between family income and childhood obesity for White but not Black families. Conclusions: The protective effect of income against childhood obesity is smaller for Blacks than Whites. Merely equalizing population access to SES and economic resources would not be sufficient for elimination of racial disparities in obesity and related cardiovascular disease in the United States. Policies should go beyond access to SES and address structural barriers in the lives of Blacks which result in a diminished health return of very same SES resources for them. As the likely causes are multi-level barriers, multi-level interventions are needed to eliminate racial disparities in childhood obesity.

The prevalence of Giardia intestinalis and Entamoeba histolytica/dispar in Van Regional Training and Research Hospital: A four-year monitoring

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Yasemin Bayram

2013-03-01

Full Text Available Objective: The aim of this retrospective study was to determinethe frequency rates of Giardia and E.histolytica/E.dispar and their distribution by years as well as agegroups and gender distribution during a four-year period.Materials and methods: A total of 9911 stool samplessent to our laboratory between January 2008 and December2011 were tested for parasites. Native-Lugol and formolethyl acetate sedimentation methods were utilized formicroscopic identification of Entamoeba sp. and Giardiatrophozoites and cysts in fresh stool samples. Additionally,trichrome staining was performed in stool sampleswhere the distinctive diagnosis could not be confirmed.Results: From a total of 9911 stool samples analyzedduring the study, 4.7% were positive for Giardia and 6.2%were positive for Entemoeba histolytica/ Entemoeba dispar.Of Giardia-positive patients 57% were male and 43%female. Similarly, 56% of Entemoeba histolytica/ Entemoebadispar positive patients were male and 44% werefemale. Both parasites’ higher frequency rates seen inmale groups were found statistically significant (p<0.01.Conclusion: It is seen that intestinal protozoon infectionsare still present as an important public health problemin our region. In order to prevent this problem, personalhygiene and sanitation rules education for community aswell as infrastructure improvements are necessary.Key words: Giardia, Entemoeba histolytica/ Entemoeba dispar, prevalence

Disparities in Quality of Park Play Spaces between Two Cities with Diverse Income and Race/Ethnicity Composition: A Pilot Study

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Gavin R. Jenkins

2015-07-01

Full Text Available This study investigated the differences in the quality of park play spaces between an affluent and a non-affluent community in a large US Southeastern metropolitan area. Two cities were purposefully selected to reflect differences in household income and race/ethnicity characteristics. Using the Playable Space Quality Assessment Tool (PSQAT, all parks (n = 11, with six in the affluent city, and five in the non-affluent city in these two cities were evaluated. The data were analyzed across three aspects of environmental features of the PSQAT: Location, Play Value and Care and Maintenance between parks in the two cities. The Mann-Whitney U test was used to test the study hypotheses. Results indicated significant differences between parks in the two cities in all three aspects of the PSQAT with p-values ≤ 0.03 and effect sizes of > 0.65, suggesting that the affluent city had parks of a higher quality than the non-affluent city. Significant disparity in Play Value (p = 0.009 in parks between these two communities suggests that children and young people are likely to have different experiences of the play spaces in their locality and therefore may experience different physical and psychological health benefits.

On social inequality: Analyzing the rich-poor disparity

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Eliazar, Iddo; Cohen, Morrel H.

2014-05-01

From the Old Testament to the Communist Manifesto, and from the French Revolution to the Occupy Wall Street protests, social inequality has always been at the focal point of public debate, as well as a major driver of political change. Although being of prime interest since Biblical times, the scientific investigation of the distributions of wealth and income in human societies began only at the close of the nineteenth century, and was pioneered by Pareto, Lorenz, Gini, and Pietra. The methodologies introduced by these trailblazing scholars form the bedrock of the contemporary science of social inequality. Based on this bedrock we present a new quantitative approach to the analysis of wealth and income distributions, which sets its spotlight on the most heated facet of the current global debate on social inequality-the rich-poor disparity. Our approach offers researchers highly applicable quantitative tools to empirically track and statistically analyze the growing gap between the rich and the poor.

Regional disparities in child mortality within China 1996-2004: epidemiological profile and health care coverage.

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Feng, Xing Lin; Guo, Sufang; Yang, Qing; Xu, Ling; Zhu, Jun; Guo, Yan

2011-07-01

China was one of the 68 "countdown" countries prioritized to attain Millennium Development Goals (MDG 4). The aim of this study was to analyze data on child survival and health care coverage of proven cost-effective interventions in China, with a focus on national disparities. National maternal and child mortality surveillance data were used to estimate child mortality. Coverage for proven interventions was analyzed based on data from the National Health Services Survey, National Nutrition and Health Survey, and National Immunization Survey. Consultations and qualitative field observations by experts were used to complement the Survey data. Analysis of the data revealed a significant reduction in the overall under-5 (U5) child mortality rate in China from 1996 to 2007, but also great regional disparities, with the risk of child mortality in rural areas II-IV being two- to sixfold higher than that in urban areas. Rural areas II-IV also accounted for approximately 80% of the mortality burden. More than 60% of child mortality occurred during the neonatal period, with 70% of this occurring during the first week of life. The leading causes of neonatal mortality were asphyxia at birth and premature birth; during the post-neonatal period, these were diarrhea and pneumonia, especially in less developed rural areas. Utilization of health care services in terms of both quantity and quality was positively correlated with the region's development level. A large proportion of children were affected by inadequate feeding, and the lack of safe water and essential sanitary facilities are vital indirect factors contributing to the increase in child mortality. The simulation analysis revealed that increasing access to and the quality of the most effective interventions combined with relatively low costs in the context of a comprehensive approach has the potential to reduce U5 deaths by 34%. China is on track to meet MDG 4; however, great disparities in health care do exist within

Colorectal cancer screening, perceived discrimination, and low-income and trust in doctors: a survey of minority patients

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Bhattacharya Shelley B

2009-09-01

Full Text Available Abstract Background Completion of colorectal cancer (CRC screening testing is lower among low-income and minority groups than the population as a whole. Given the multiple cancer screening health disparities known to exist within the U.S., this study investigated the relationship between perceived discrimination, trust in most doctors, and completion of Fecal Occult Blood Testing (FOBT among a low-income, minority primary care population in an urban setting. Methods We recruited a convenience sample of adults over age 40 (n = 282 from a federally qualified community health center (70% African American. Participants completed a survey which included measures of trust in most doctors, perceived discrimination, demographics and report of cancer screening. Results Participants reported high levels of trust in most doctors, regardless of sex, race, education or income. High trust was associated with low perceived discrimination (p Conclusion Perceived discrimination was related to income, but not race, suggesting that discrimination is not unique to minorities, but common to those in poverty. Since trust in most doctors trended toward being related to age, FOBT screening could be negatively influenced by low trust and perceived discrimination in health care settings. A failure to address these issues in middle-aged, low income individuals could exacerbate future disparities in CRC screening.

Uncovering regional disparity of China's water footprint and inter-provincial virtual water flows.

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Dong, Huijuan; Geng, Yong; Fujita, Tsuyoshi; Fujii, Minoru; Hao, Dong; Yu, Xiaoman

2014-12-01

With rapid economic development in China, water crisis is becoming serious and may impede future sustainable development. The uneven distribution of water resources further aggravates such a problem. Under such a circumstance, the concepts of water footprint and virtual water have been proposed in order to respond water scarcity problems. This paper focuses on studying provincial disparity of China's water footprints and inter-provincial virtual water trade flows by adopting inter-regional input-output (IRIO) method. The results show that fast developing areas with larger economic scales such as Guangdong, Jiangsu, Shandong, Zhejiang, Shanghai and Xinjiang had the largest water footprints. The most developed and water scarce areas such as Shanghai, Beijing, Tianjin and Shandong intended to import virtual water, a rational choice for mitigating their water crisis. Xinjiang, Jiangsu, Heilongjiang, Inner Mongolia, Guangxi and Hunan, had the largest per GDP water intensities and were the main water import regions. Another key finding is that agriculture water footprint was the main part in water footprint composition and water export trade. On the basis of these findings, policy implications on agriculture geographical dispersion, consumption behavior changes, trade structure adjustment and water use efficiency improvement are further discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

Early adolescent childbearing in low- and middle-income countries: associations with income inequity, human development and gender equality.

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Decker, Michele R; Kalamar, Amanda; Tunçalp, Özge; Hindin, Michelle J

2017-03-01

Reducing unwanted adolescent childbearing is a global priority. Little is known about how national-level economic and human development indicators relate to early adolescent childbearing. This ecological study evaluates associations of Gross Domestic Product (GDP), GINI index, Human Development Index (HDI) and Gender-related Development Index (GDI; i.e. the HDI adjusted for gender disparities) with early adolescent childbearing in 27 low- and middle-income countries (LMICs) across three time periods. Among women ages 18–24, prevalence estimates for early birth (development adjusted for gender disparities in educational and economic prospects, was more consistently related to early adolescent childbearing than the absolute development prospects as given by the HDI. While creating gender equality is an important goal in and of itself, the findings emphasize the potential for improved national-level gender equitable development as a means to improve adolescents’ sexual and reproductive health.

Self-esteem and socioeconomic disparities in self-perceived oral health.

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Locker, David

2009-01-01

To determine if psychosocial factors explain the socioeconomic disparities in self-perceived oral health that persist after controlling for oral status variables. Data came from the participants in the Canadian Community Health Survey 2003 who were residents in the city of Toronto. Oral health variables included self-rated oral health, a 13-item oral health scale, denture wearing, and having a tooth extracted in the previous year. The last two measures were regarded as proxy indicators of tooth loss. Psychosocial variables included a self-esteem scale, a depression scale, and single items measuring life satisfaction, life stress, and sense of cohesion. Socioeconomic status was assessed using total annual household income. Interviews were completed with 2,754 dentate persons aged 20 years and over. Bivariate analyses confirmed that there were income gradients in self-rated oral health and scores on the oral health scale. Linear regression analyses confirmed that these persisted after controlling for age, gender, denture wearing, and having a tooth extracted in the previous year. In the model predicting self-rated oral health self-esteem, life satisfaction, stress, a sense of cohesion, and depression also contributed to the model, increased its explanatory power, and reduced the strength of but did not eliminate the association between income and self-rated oral health. Broadly, similar results were obtained when the oral health scale score was used as the dependent variable. In both analyses and all models, denture wearing had the strongest and most enduring effect. Psychosocial factors partly but do not wholly explain the socioeconomic disparities in self-perceived oral health in this population after controlling for tooth loss and denture wearing. Other variables need to be added to the models to increase their explanatory power.

Cancer Disparities

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Basic information about cancer disparities in the U.S., factors that contribute to the disproportionate burden of cancer in some groups, and examples of disparities in incidence and mortality among certain populations.

Sociodemographic Disparities in Local Smoke-Free Law Coverage in 10 States.

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Huang, Jidong; King, Brian A; Babb, Stephen D; Xu, Xin; Hallett, Cynthia; Hopkins, Maggie

2015-09-01

We assessed sociodemographic disparities in local 100% smoke-free laws prohibiting smoking in all indoor areas of nonhospitality worksites, restaurants, and bars in 10 states. We obtained data on local 100% smoke-free laws (US Tobacco Control Laws Database) and subcounty characteristics (2006-2010 American Community Survey) for Alabama, Alaska, Indiana, Kentucky, Mississippi, Missouri, North Dakota, South Carolina, Texas, and West Virginia. Outcomes included (1) 100% smoke-free law covering restaurants, bars, and workplaces; (2) 100% smoke-free law covering restaurants, bars, or workplaces; and (3) number of venue types covered by 100% smoke-free laws (0-3). Sociodemographics included total population, urban status, percentage racial/ethnic minority, per capita income, percentage with high-school diploma, percentage with blue-collar jobs, and percentage of workers who live and work in the same locality. Across states, localities with less-educated residents, smaller proportions of workers living and working in the same locality, or both generally had lower odds of being covered by 100% smoke-free laws. Coverage varied across states for other sociodemographics. Disparities exist in local smoke-free law coverage. Identifying patterns in coverage can inform state efforts to address related disparities.

Urban vegetation and income segregation in drylands: a synthesis of seven metropolitan regions in the southwestern United States

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Jenerette, G Darrel; Buyantuev, Alexander; Miller, Greg; Pataki, Diane E; Gillespie, Thomas W; Pincetl, Stephanie

2013-01-01

To better understand how urbanization affects the amount and timing of urban vegetation in drylands we investigated remotely sensed vegetation patterns across seven large metropolitan regions in the southwestern United States. We asked (1) how low density urban land cover differed from adjacent wildland grass, herb, and shrub land covers in both the amount of vegetation and the length of the growing season, (2) how neighborhood income affected patterns of vegetation within low density urban cover, and (3) how cities differed from one another in their vegetation patterns. We found that urbanization generally has a strong influence on vegetation compared to adjacent wildlands. In four of the metropolitan regions the cumulative enhanced vegetation index (EVI) and growing season length in low density developments were higher than grass, herb, and shrub land covers. Within all metropolitan regions, there was a significant socioeconomic effect where higher income areas had a higher cumulative EVI than lower income areas. The large differences in urban vegetation among cities were related to precipitation and total domestic water use. These findings help to identify how urbanization influences vegetation, with implications for the availability of ecosystem services and requirements for irrigation in hot dryland cities. (letter)

Implementation of Local Wellness Policies in Schools: Role of School Systems, School Health Councils, and Health Disparities.

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Hager, Erin R; Rubio, Diana S; Eidel, G Stewart; Penniston, Erin S; Lopes, Megan; Saksvig, Brit I; Fox, Renee E; Black, Maureen M

2016-10-01

Written local wellness policies (LWPs) are mandated in school systems to enhance opportunities for healthy eating/activity. LWP effectiveness relies on school-level implementation. We examined factors associated with school-level LWP implementation. Hypothesized associations included system support for school-level implementation and having a school-level wellness team/school health council (SHC), with stronger associations among schools without disparity enrollment (majority African-American/Hispanic or low-income students). Online surveys were administered: 24 systems (support), 1349 schools (LWP implementation, perceived system support, SHC). The state provided school demographics. Analyses included multilevel multinomial logistic regression. Response rates were 100% (systems)/55.2% (schools). Among schools, 44.0% had SHCs, 22.6% majority (≥75%) African-American/Hispanic students, and 25.5% majority (≥75%) low-income (receiving free/reduced-price meals). LWP implementation (17-items) categorized as none = 36.3%, low (1-5 items) = 36.3%, high (6+ items) = 27.4%. In adjusted models, greater likelihood of LWP implementation was observed among schools with perceived system support (high versus none relative risk ratio, RRR = 1.63, CI: 1.49, 1.78; low versus none RRR = 1.26, CI: 1.18, 1.36) and SHCs (high versus none RRR = 6.8, CI: 4.07, 11.37; low versus none RRR = 2.24, CI: 1.48, 3.39). Disparity enrollment did not moderate associations (p > .05). Schools with perceived system support and SHCs had greater likelihood of LWP implementation, with no moderating effect of disparity enrollment. SHCs/support may overcome LWP implementation obstacles related to disparities. © 2016, American School Health Association.

Disparities in the receipt of fecal occult blood test versus endoscopy among Filipino American immigrants.

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Maxwell, Annette E; Danao, Leda L; Crespi, Catherine M; Antonio, Cynthia; Garcia, Gabriel M; Bastani, Roshan

2008-08-01

This report examines disparities associated with the type of colorectal screening test, fecal occult blood test versus endoscopy, within a particular racial/ethnic group, Filipino American immigrants. Between July 2005 and October 2006, Filipino Americans aged 50 to 75 years from 31 community organizations in Los Angeles completed a 15-minute survey in English (65%) or Filipino (35%). Of the 487 respondents included in this analysis, 257 (53%) had never received any type of colorectal cancer screening. Among the 230 subjects who had ever received a routine screening test, 78 had fecal occult blood test only (16% of the total sample), and 152 had endoscopy with or without fecal occult blood test (31% of the total sample). After controlling for access to care and key demographic variables in a multivariate analysis, only two characteristics distinguished between respondents who had fecal occult blood test only versus those who had endoscopy: acculturation, assessed by percent lifetime in the United States and language of interview, and income. Our data suggest a two-tier system, fecal occult blood test for less acculturated Filipino Americans with lower income versus endoscopy for Filipino immigrants with higher levels of acculturation and income. The disparity persists after adjusting for access to care. Instead of treating minority groups as monolithic, differences within groups need to be examined so that interventions can be appropriately targeted.

Health Disparities

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... Health and Health Disparities conduct transdisciplinary research involving social, behavioral, biological, and genetic research to improve knowledge of the causes of health disparities and devise effective methods of preventing, diagnosing, and treating disease and promoting ...

Initiating the Pathway to Increase the Region's Income by Developing Tourism Village of Panglipuran Bali

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M. Bashori Imron

2015-12-01

Full Text Available The head of regencies and cities needs to develop their imagination and inspiration in order to present the goal of region development and deliver the positive economic growth for the public. Initiating the tourism village program for the potential area may serve as a creative alternative. The aim of this research is to develop the idea of tourism village to improve the income of the region. In depth participation in the community and intensive interview with the tourism stakeholders have been chosen as the method of this study. The result of the research shows that the tourism village of Penglipuran has seven potentials as the main attractions as represented by the traditional architecture, artistic spatial arrangement, the bamboo forest, heroes cemetery, the beauty of Pura Panataran, remarkable village landscape, and Karang Memadu. The participation of local government may contribute the positive impact for the economic growth and improve the income of local community.

Specialisation and Convergence in European Regions

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Enrico Marelli

2007-09-01

Full Text Available The purpose of this paper was to analyze specialization and convergence of European countries and regions, within the framework of integration in the EU. This is important not only for long-term real convergence processes, but also for a proper functioning of the monetary union (in the line of research on the OCA's criteria, asymmetry of shocks and synchronization of business cycles. The position of new member states is particularly delicate, also considering the forthcoming adoption of the euro by some of them. As indicated by the EU Treaty, economic growth should be balanced with economic and social cohesion that includes a careful consideration of regional disparities. Our empirical investigation focuses on the regions of EU25, further broken up into other relevant groupings (EU15, EMU, and the new members' EU10 group, over the period from 1980 (or 1990 for EU10 to 2005. This paper considers a rather fine regional disaggregation (NUTS-2 level, counting 250 regions. The analysis of different indices of specialisation point to a prevalent increase of homogeneity of sector structures across European regions, although in some cases (especially in the industrial sector and in some services specialisation has increased. For convergence, a sigma convergence's analysis confirms a reduction of disparities, both at a country and regional level. However, a trade-off between fast national growth and internal distribution has emerged in the early stages of development, as in the case of new members. Moreover, beta convergence has also been established - regarding per capita income, employment and productivity - for almost all territorial aggregates (excluding the new members since 1999. The addition of structural variables, following a beta-conditional approach, indicates a positive role for services and a negative impact of agriculture. Finally, some preliminary results have been obtained by the innovative inclusion of specialisation indices within

Trends in Income Disparity and Equality Enhancing (?) Education Policies in the Development Stages of Singapore

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Mukhopadhaya, P.

2003-01-01

This paper examines the trends in income diversity in Singapore at the total and disaggregated level using Labour Force Survey data. The income inequality in Singapore is found to be significantly high. One reason is the selective migration policy of the government of Singapore. The government has made conscious efforts to bring equality in…

Trends in Longevity in the Americas: Disparities in Life Expectancy in Women and Men, 1965-2010.

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Ian R Hambleton

Full Text Available We describe trends in life expectancy at birth (LE and between-country LE disparities since 1965, in Latin America and the Caribbean.LE trends since 1965 are described for three geographical sub-regions: the Caribbean, Central America, and South America. LE disparities are explored using a suite of absolute and relative disparity metrics, with measurement consensus providing confidence to observed differences. LE has increased throughout Latin America and the Caribbean. Compared to the Caribbean, LE has increased by an additional 6.6 years in Central America and 4.1 years in South America. Since 1965, average reductions in between-country LE disparities were 14% (absolute disparity and 23% (relative disparity in the Caribbean, 55% and 51% in Central America, 55% and 52% in South America.LE in Latin America and the Caribbean is exceeding 'minimum standard' international targets, and is improving relative to the world region with the highest human longevity. The Caribbean, which had the highest LE and the lowest between-country LE disparities in Latin America and the Caribbean in 1965-70, had the lowest LE and the highest LE disparities by 2005-10. Caribbean Governments have championed a collaborative solution to the growing burden of non-communicable disease, with 15 territories signing on to the Declaration of Port of Spain, signalling regional commitment to a coordinated public-health response. The persistent LE inequity between Caribbean countries suggests that public health interventions should be tailored to individual countries to be most effective. Between- and within-country disparity monitoring for a range of health metrics should be a priority, first to guide country-level policy initiatives, then to contribute to the assessment of policy success.

Decomposing Racial/Ethnic Disparities in Influenza Vaccination among the Elderly

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Yoo, Byung-Kwang; Hasebe, Takuya; Szilagyi, Peter G.

2015-01-01

While persistent racial/ethnic disparities in influenza vaccination have been reported among the elderly, characteristics contributing to disparities are poorly understood. This study aimed to assess characteristics associated with racial/ethnic disparities in influenza vaccination using a nonlinear Oaxaca-Blinder decomposition method. We performed cross-sectional multivariable logistic regression analyses for which the dependent variable was self-reported receipt of influenza vaccine during the 2010–2011 season among community dwelling non-Hispanic African-American (AA), non-Hispanic White (W), English-speaking Hispanic (EH) and Spanish-speaking Hispanic (SH) elderly, enrolled in the 2011 Medicare Current Beneficiary Survey (MCBS) (un-weighted/weighted N= 6,095/19.2million). Using the nonlinear Oaxaca-Blinder decomposition method, we assessed the relative contribution of seventeen covariates—including socio-demographic characteristics, health status, insurance, access, preference regarding healthcare, and geographic regions —to disparities in influenza vaccination. Unadjusted racial/ethnic disparities in influenza vaccination were 14.1 percentage points (pp) (W-AA disparity, p.8). The Oaxaca-Blinder decomposition method estimated that the unadjusted W-AA and W-SH disparities in vaccination could be reduced by only 45% even if AA and SH groups become equivalent to Whites in all covariates in multivariable regression models. The remaining 55% of disparities were attributed to (a) racial/ethnic differences in the estimated coefficients (e.g., odds ratios) in the regression models and (b) characteristics not included in the regression models. Our analysis found that only about 45% of racial/ethnic disparities in influenza vaccination among the elderly could be reduced by equalizing recognized characteristics among racial/ethnic groups. Future studies are needed to identify additional modifiable characteristics causing disparities in influenza vaccination. PMID

Assessing the contribution of the dental care delivery system to oral health care disparities.

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Pourat, Nadereh; Andersen, Ronald M; Marcus, Marvin

2015-01-01

Existing studies of disparities in access to oral health care for underserved populations often focus on supply measures such as number of dentists. This approach overlooks the importance of other aspects of the dental care delivery system, such as personal and practice characteristics of dentists, that determine the capacity to provide care. This study aims to assess the role of such characteristics in access to care of underserved populations. We merged data from the 2003 California Health Interview Survey and a 2003 survey of California dentists in their Medical Study Service Areas (MSSAs). We examined the role of overall supply and other characteristics of dentists in income and racial/ethnic disparities in access, which was measured by annual dental visits and unmet need for dental care due to costs. We found that some characteristics of MSSAs, including higher proportions of dentists who were older, white, busy or overworked, and did not accept public insurance or discounted fees, inhibited access for low-income and minority populations. These findings highlight the importance of monitoring characteristics of dentists in addition to traditional measures of supply such as licensed-dentist-to-population ratios. The findings identify specific aspects of the delivery system such as dentists' participation in Medicaid, provision of discounted care, busyness, age, race/ethnicity, and gender that should be regularly monitored. These data will provide a better understanding of how the dental care delivery system is organized and how this knowledge can be used to develop more narrowly targeted policies to alleviate disparities. © 2014 American Association of Public Health Dentistry.

Neighbourhood economic deprivation explains racial/ethnic disparities in overweight and obesity among children and adolescents in the U.S.A.

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Rossen, Lauren M

2014-02-01

Low-income and some racial and ethnic subpopulations are more likely to suffer from obesity. Inequities in the physical and social environment may contribute to disparities in paediatric obesity, but there is little empirical evidence to date. This study explored whether neighbourhood-level socioeconomic factors attenuate racial and ethnic disparities in obesity among youth in the U.S.A. and whether individual-level socioeconomic status (SES) interacts with neighbourhood deprivation. This analysis used data from 17,100 youth ages 2-18 years participating in the 2001-2010 National Health and Nutrition Examination Survey linked to census tract-level socioeconomic characteristics. Multilevel logistic regression models were used to examine neighbourhood deprivation in association with odds of obesity (age-specific and sex-specific body mass index percentile ≥95). The unadjusted prevalence of obesity was 15% among non-Hispanic white children and 21% among non-Hispanic black and Mexican-American children. Adjustment for individual-level SES neighbourhood deprivation and the interaction between these two factors resulted in a 74% attenuation of the disparity in obesity between non-Hispanic black and non-Hispanic white children and a 49% attenuation of the disparity between Mexican-American and non-Hispanic white children. There was a significant interaction between individual-level SES and neighbourhood deprivation where higher individual-level income was protective for children living in low-deprivation neighbourhoods, but not for children who lived in high-deprivation areas. Conversely, area deprivation was associated with higher odds of obesity, but only among children who were above the poverty threshold. Future research on disparities in obesity and other health outcomes should examine broader contextual factors and social determinants of inequities.

Analyzing Turkey's data from TIMSS 2007 to investigate regional disparities in eighth grade science achievement

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Erberber, Ebru

Turkey is expected to be a full member of the European Union (EU) by 2013. In the course of its integration into the EU, Turkey has been simultaneously facing access, quality, and equity issues in education. Over the past decade, substantial progress has been made on increasing the access. However, improving the country's low level of education quality and achieving equity in quality education across the regions continue to be a monumental challenge in Turkey. Most recently, results from the Trends in International Mathematics and Science Study (TIMSS) 2007 indicated that Turkey's educational achievement at the eighth grade, the end of compulsory primary education in Turkey, was far below that of other countries in the EU. Considering Turkey's long standing socioeconomic disparities between the western and eastern parts of the country, the challenges of improving overall education quality are coupled with the challenges of achieving equity in learning outcomes for students across the regions. This dissertation used data from TIMSS 2007 to document the extent of Turkey's regional differences in science achievement at the eighth grade and to investigate factors associated with these differences. Findings from a series of analyses using hierarchical linear models suggested that attempts to increase Turkish students' achievement and close the achievement gaps between regions should target the students in the undeveloped regions, particularly in Southeastern Anatolia and Eastern Anatolia. Designing interventions to improve competency in Turkish and to compensate for the shortcomings of insufficient parental education, limited home educational resources, poor school climate for academic achievement, and inadequate instructional equipment and facilities might be expected to close the regional achievement gaps as well as raise the overall achievement level in Turkey.

Geographic disparity in kidney transplantation under KAS.

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Zhou, Sheng; Massie, Allan B; Luo, Xun; Ruck, Jessica M; Chow, Eric K H; Bowring, Mary G; Bae, Sunjae; Segev, Dorry L; Gentry, Sommer E

2017-12-12

The Kidney Allocation System fundamentally altered kidney allocation, causing a substantial increase in regional and national sharing that we hypothesized might impact geographic disparities. We measured geographic disparity in deceased donor kidney transplant (DDKT) rate under KAS (6/1/2015-12/1/2016), and compared that with pre-KAS (6/1/2013-12/3/2014). We modeled DSA-level DDKT rates with multilevel Poisson regression, adjusting for allocation factors under KAS. Using the model we calculated a novel, improved metric of geographic disparity: the median incidence rate ratio (MIRR) of transplant rate, a measure of DSA-level variation that accounts for patient casemix and is robust to outlier values. Under KAS, MIRR was 1.75 1.81 1.86 for adults, meaning that similar candidates across different DSAs have a median 1.81-fold difference in DDKT rate. The impact of geography was greater than the impact of factors emphasized by KAS: having an EPTS score ≤20% was associated with a 1.40-fold increase (IRR =  1.35 1.40 1.45 , P geographic disparities with KAS (P = .3). Despite extensive changes to kidney allocation under KAS, geography remains a primary determinant of access to DDKT. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Fiscal Decentralization and Disparity of Access to Primary Education in Indonesia

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Shinta Doriza

2013-12-01

Full Text Available In education, one crusial issue of development is the disparity of primary education access. Using 440 regions database from 2005-2009, this study is aim to analize the impact of fiscal decentralization in reducing the enrolement of primary education in Indonesia. Three factors were included, i.e fiscal decentralization, socioeconomic factors and regional characteristics. The result of panel data estimation using fixed-effect approach on this study is that DAK for Education, DAK Non Education, and PAD have significant impact in reducing education acess disparity along with poverty and regional characteristic such as Java-non Java regions. For education level, another variable was also found significant including education of the society and regional characteristic such as proliferated-non proliferated regions. In general there is a facts and proves that fiscal decentralization improve education access equality, but several effort need to done to optimalize the equalization of primary education access in Indonesia.

Income disparities and their impact on the level and development of food expenditures of households in Slovakia

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Ľudmila Nagyová

2013-01-01

Full Text Available Paper evaluates development and changes in the level of households food expenditures in Slovakia, which occurred after the accession of Slovakia to the European Union in 2004 and began to apply the rules of the Common Agricultural Policy and using of means of support. Free movement of goods, labor and capital has contributed to the increase of goods and services supply and living standards as well as to the increase in households income differentiation. Until 2012, households in the lowest income quartile possess on average with only 34.1 % per year of the revenue compared with income in the highest fourth quartile of income category. The results of the analysis show a different behavior in the food market. Most sensitive to the change in income and price levels of food expenditures for food responded in families with the lowest incomes (EI = 0.28. With the increase in prices of cereals (bread by one percentage unit-demand declined by an average by 0.49 % (Epi = −0.49, the demand for cheese by 0.65 % (Epi = −0.654 and the demand for meat by 0.275 % (Epi = −0.275.

Health Literacy, Health Disparities, and Sources of Health Information in U.S. Older Adults.

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Cutilli, Carolyn Crane; Simko, Lynn C; Colbert, Alison M; Bennett, Ian M

Low health literacy in older adults has been associated with poor health outcomes (i.e., mortality, decreased physical and cognitive functioning, and less preventive care utilization). Many factors associated with low health literacy are also associated with health disparities. Interaction with healthcare providers and sources of health information are influenced by an individual's health literacy and can impact health outcomes. This study examined the relationships between health literacy, sources of health information, and demographic/background characteristics in older adults (aged 65 years and older) related to health literacy and disparities. This descriptive, correlational study is a secondary analysis of the 2003 National Assessment of Adult Literacy, a large-scale national assessment. Older adults with lower health literacy have less income and education, rate their health as poor or fair, have visual or auditory difficulties, need help filling out forms, reading newspaper, or writing notes, and use each source of health information less (print and nonprint). Many of these characteristics and skills are predictive of health literacy and associated with health disparities. The results expand our knowledge of characteristics associated with health literacy and sources of health information used by older adults. Interventions to improve health outcomes including health disparities can focus on recognizing and meeting the health literacy demands of older adults.

Understanding health-care access and utilization disparities among Latino children in the United States.

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Langellier, Brent A; Chen, Jie; Vargas-Bustamante, Arturo; Inkelas, Moira; Ortega, Alexander N

2016-06-01

It is important to understand the source of health-care disparities between Latinos and other children in the United States. We examine parent-reported health-care access and utilization among Latino, White, and Black children (≤17 years old) in the United States in the 2006-2011 National Health Interview Survey. Using Blinder-Oaxaca decomposition, we portion health-care disparities into two parts (1) those attributable to differences in the levels of sociodemographic characteristics (e.g., income) and (2) those attributable to differences in group-specific regression coefficients that measure the health-care 'return' Latino, White, and Black children receive on these characteristics. In the United States, Latino children are less likely than Whites to have a usual source of care, receive at least one preventive care visit, and visit a doctor, and are more likely to have delayed care. The return on sociodemographic characteristics explains 20-30% of the disparity between Latino and White children in the usual source of care, delayed care, and doctor visits and 40-50% of the disparity between Latinos and Blacks in emergency department use and preventive care. Much of the health-care disadvantage experienced by Latino children would persist if Latinos had the sociodemographic characteristics as Whites and Blacks. © The Author(s) 2014.

Identification of racial disparities in breast cancer mortality: does scale matter?

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Zhan F Benjamin

2010-07-01

Full Text Available Abstract Background This paper investigates the impact of geographic scale (census tract, zip code, and county on the detection of disparities in breast cancer mortality among three ethnic groups in Texas (period 1995-2005. Racial disparities were quantified using both relative (RR and absolute (RD statistics that account for the population size and correct for unreliable rates typically observed for minority groups and smaller geographic units. Results were then correlated with socio-economic status measured by the percentage of habitants living below the poverty level. Results African-American and Hispanic women generally experience higher mortality than White non-Hispanics, and these differences are especially significant in the southeast metropolitan areas and southwest border of Texas. The proportion and location of significant racial disparities however changed depending on the type of statistic (RR versus RD and the geographic level. The largest proportion of significant results was observed for the RD statistic and census tract data. Geographic regions with significant racial disparities for African-Americans and Hispanics frequently had a poverty rate above 10.00%. Conclusions This study investigates both relative and absolute racial disparities in breast cancer mortality between White non-Hispanic and African-American/Hispanic women at the census tract, zip code and county levels. Analysis at the census tract level generally led to a larger proportion of geographical units experiencing significantly higher mortality rates for minority groups, although results varied depending on the use of the relative versus absolute statistics. Additional research is needed before general conclusions can be formulated regarding the choice of optimal geographic regions for the detection of racial disparities.

Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma.

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Ejebe, Ifna H; Jacobs, Elizabeth A; Wisk, Lauren E

2015-02-01

The objective of this population-based study was to determine if and to what extent there are differences in asthma self-efficacy by race/ethnicity and income, and whether health status, levels of acculturation, and health care factors may explain these differences. We conducted a secondary data analysis of asthma self-efficacy using the 2009 and 2011-2012 California Health Interview Survey, in adults with asthma (n=7874). In order to examine if and how the effect of race/ethnicity and income on asthma self-efficacy may have been altered by health status, acculturation, and health care factors, we used staged multivariable logistic regression models. We conducted mediation analyses to evaluate which of these factors might mediate disparities in self-efficacy by race/ethnicity and income. 69.8% of adults reported having high asthma self-efficacy. Latinos (OR 0.66; 95% CI 0.51-0.86), African-Americans (OR 0.50; 95% CI 0.29-0.83), American Indian/Alaskan Natives (OR 0.55; 95% CI 0.31-0.98) and Asian/Pacific Islanders (OR 0.34; 95% CI 0.23-0.52) were less likely to report high self-efficacy compared to Whites. Individuals with income below the federal poverty level (OR 0.56; 95% CI 0.40-0.78) were less likely to report high self-efficacy compared to higher income individuals. The relationship between income and self-efficacy was no longer significant after further adjustment for health care factors; however, the differences in race and ethnicity persisted. Receiving an asthma management plan mediated the relationship in certain subgroups. Addressing modifiable health care factors may play an important role in reducing disparities in asthma self-efficacy.

Digital divide and body size disparities among Chinese adults

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Chih-Chien Huang

2018-01-01

Full Text Available Background: The rapid development of information and communication technology (ICT in China has increased people's sedentary behavior and raised a number of related issues. ICT screen-viewing activities are increasingly considered to contribute to obesity, and sociodemographic characteristics such as gender, income, age, education, and geographical location seem to magnify the digital divide. Objective: This study first examines dissimilar stages of ICT transition, and then establishes how ICT screen-viewing activities relate to the Chinese obesity epidemic. Finally, this study assesses whether unequal access to digital resources and technology by geographic location and gender reinforces existing obesity disparities in China. Methods: This study uses longitudinal data drawn from 10,616 households and 17,377 person-years of those aged 18-55 who participated in the 2006, 2009, and 2011 China Health and Nutrition Survey (CHNS. Fixed effect linear regression models capture the link between ICT screen-viewing activities and body mass index (BMI. Results: The results show that while between 91.37Š and 96.70Š of individuals had access to televisions during 2006-2011, there is a significant disparity in terms of Internet activity by gender and geographical location. The results show that Internet use could decrease a rural women's BMI by .87 kg/m2, while playing computer games could increase a rural man's BMI by .42 kg/m2. Contribution: This study highlights that unequal access to digital resources and technology might reinforce existing obesity disparities in China.

Nations’ Income Inequality Predicts Ambivalence in Stereotype Content: How Societies Mind the Gap

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Durante, Federica; Fiske, Susan T.; Kervyn, Nicolas; Cuddy, Amy J. C.; Akande, Adebowale (Debo); Adetoun, Bolanle E.; Adewuyi, Modupe F.; Tserere, Magdeline M.; Ramiah, Ananthi Al; Mastor, Khairul Anwar; Barlow, Fiona Kate; Bonn, Gregory; Tafarodi, Romin W.; Bosak, Janine; Cairns, Ed; Doherty, Claire; Capozza, Dora; Chandran, Anjana; Chryssochoou, Xenia; Iatridis, Tilemachos; Contreras, Juan Manuel; Costa-Lopes, Rui; González, Roberto; Lewis, Janet I.; Tushabe, Gerald; Leyens, Jacques-Philippe; Mayorga, Renée; Rouhana, Nadim N.; Castro, Vanessa Smith; Perez, Rolando; Rodríguez-Bailón, Rosa; Moya, Miguel; Morales Marente, Elena; Palacios Gálvez, Marisol; Sibley, Chris G.; Asbrock, Frank; Storari, Chiara C.

2013-01-01

Income inequality undermines societies: the more inequality, the more health problems, social tensions, and the lower social mobility, trust, life expectancy. Given people’s tendency to legitimate existing social arrangements, the Stereotype Content Model (SCM) argues that ambivalence—perceiving many groups as either warm or competent, but not both—may help maintain socio-economic disparities. The association between stereotype ambivalence and income inequality in 37 cross-national samples from Europe, the Americas, Oceania, Asia, and Africa investigates how groups’ overall warmth-competence, status-competence, and competition-warmth correlations vary across societies, and whether these variations associate with income inequality (Gini index). More unequal societies report more ambivalent stereotypes, while more equal ones dislike competitive groups and do not necessarily respect them as competent. Unequal societies may need ambivalence for system stability: income inequality compensates groups with partially positive social images. PMID:23039178

Prioritizing health disparities in medical education to improve care

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Awosogba, Temitope; Betancourt, Joseph R.; Conyers, F. Garrett; Estapé, Estela S.; Francois, Fritz; Gard, Sabrina J.; Kaufman, Arthur; Lunn, Mitchell R.; Nivet, Marc A.; Oppenheim, Joel D.; Pomeroy, Claire; Yeung, Howa

2015-01-01

Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. PMID:23659676

Prioritizing health disparities in medical education to improve care.

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Awosogba, Temitope; Betancourt, Joseph R; Conyers, F Garrett; Estapé, Estela S; Francois, Fritz; Gard, Sabrina J; Kaufman, Arthur; Lunn, Mitchell R; Nivet, Marc A; Oppenheim, Joel D; Pomeroy, Claire; Yeung, Howa

2013-05-01

Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. © 2013 New York Academy of Sciences.

Multiple disparities in adult mortality in relation to social and health care perspective: results from different data sources.

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Ranabhat, Chhabi Lal; Kim, Chun-Bae; Park, Myung-Bae; Acharaya, Sambhu

2017-08-08

Disparity in adult mortality (AM) with reference to social dynamics and health care has not been sufficiently examined. This study aimed to identify the gap in the understanding of AM in relation to religion, political stability, economic level, and universal health coverage (UHC). A cross-national study was performed with different sources of data, using the administrative record linkage theory. Data was created from the 2013 World Bank data catalogue by region, The Economist (Political instability index 2013), Stuckler David et al. (Universal health coverage, 2010), and religious categories of all UN country members. Descriptive statistics, a t-test, an ANOVA followed by a post hoc test, and a linear regression were used where applicable. The average AM rate for males and females was 0.20 ± 0.10 and 0.14 ± 0.10, respectively. There was high disparity of AM between countries with and without UHC and between groups with low and high income. UHC and political stability would significantly reduce AMR by >0.41 in both sexes and high economic status would reduce male AMR by 0.44, and female AMR by 0.70. It can be concluded that effective health care; UHC and political stability significantly reduce AM.

Disparities in the use of preventive health care among children with disabilities in Taiwan.

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Tsai, Wen-Chen; Kung, Pei-Tseng; Wang, Jong-Yi

2012-01-01

Children with disabilities face more barriers accessing preventive health services. Prior research has documented disparities in the receipt of these services. However, most are limited to specific types of disability or care. This study investigates disparities in the use of preventive health care among children with disabilities in Taiwan. Three nationwide databases from the Ministry of the Interior, Bureau of Health Promotion, and National Health Research Institutes were linked to gather related information between 2006 and 2008. A total of 8572 children with disabilities aged 1-7 years were included in this study. Multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 37.58% of children with disabilities received preventive health care in 2008. Children with severe and very severe disabilities were less likely to use preventive care than those with mild severity. Children with disabilities from the lowest income family were less likely to have preventive care than other income groups. Urbanization was strongly associated with the receipt of preventive health care. However, surprisingly, urban children with disabilities were less likely to receive preventive care than all others. Under universal health insurance coverage, the overall usage of preventive health care is still low among children with disabilities. The study also identified several disparities in their usage. Potential factors affecting the lack of use deserve additional research. Policymakers should target low socioeconomic brackets and foster education about the importance of preventive care. Mobile health services should be continually provided in those areas in need. Capitation reimbursement and other incentives should be considered in improving the utilization among children with disabilities. Copyright © 2011 Elsevier Ltd. All rights reserved.

Prenatal and Postpartum Care Disparities in a Large Medicaid Program.

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Parekh, Natasha; Jarlenski, Marian; Kelley, David

2018-03-01

Objectives Pennsylvania's maternal mortality, infant mortality, and preterm birth rates rank 24th, 35th, and 25th in the country, and are higher among racial and ethnic minorities. Provision of prenatal and postpartum care represents one way to improve these outcomes. We assessed the extent of disparities in the provision and timeliness of prenatal and postpartum care for women enrolled in Pennsylvania Medicaid. Methods We performed a cross-sectional evaluation of representative samples of women who delivered live births from November 2011 to 2015. Our outcomes were three binary effectiveness-of-care measures: prenatal care timeliness, frequency of prenatal care, and postpartum care timeliness. Pennsylvania's Managed Care Organizations (MCOs) were required to submit these outcomes to the state after reviewing administrative and medical records through a standardized, validated sampling process. We assessed for differences in outcomes by race, ethnicity, region, year, and MCO using logistic regression. Results We analyzed data for 12,228 women who were 49% White, 31% Black/African American, 4% Asian, and 15% Hispanic/Latina. Compared to Black/African American women, white and Asian women had higher odds of prenatal and postpartum care. Hispanic/Latina women had higher frequency of prenatal care than non-Hispanic women. Pennsylvania's Southeast had lower prenatal care and Northwest had lower postpartum care than other regions. Prenatal care significantly decreased in 2014 and increased in 2015. We observed differences between MCOs, and as MCO performance diminished, racial disparities within each plan widened. We explored hypotheses for observed disparities in secondary analyses. Conclusions for Practice Our data demonstrate that interventions should address disparities by race, region, and MCO in equity-promoting measures.

Engendering health disparities.

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Spitzer, Denise L

2005-01-01

How is gender implicated in our exploration of health disparities in Canada? Set against the backdrop of federal government policy, this review paper examines the ways in which gender intersects with other health determinants to produce disparate health outcomes. An overview of salient issues including the impact of gender roles, environmental exposures, gender violence, workplace hazards, economic disparities, the costs of poverty, social marginalization and racism, aging, health conditions, interactions with health services, and health behaviours are considered. This review suggests health is detrimentally affected by gender roles and statuses as they intersect with economic disparities, cultural, sexual, physical and historical marginalization as well as the strains of domestic and paid labour. These conditions result in an unfair health burden borne in particular by women whose access to health determinants is--in various degrees--limited. While progress has certainly been made on some fronts, the persistence of health disparities among diverse populations of women and men suggests a postponement of the vision of a just society with health for all that was articulated in the Federal Plan on Gender Equality. Commitment, creativity and collaboration from stakeholders ranging from various levels of government, communities, academics, non-governmental agencies and health professionals will be required to reduce and eliminate health disparities between and among all members of our society.

Understanding China’s electricity market reform from the perspective of the coal-fired power disparity

International Nuclear Information System (INIS)

Mou, Dunguo

2014-01-01

In China, electricity consumption has grown quickly, supply is highly dependent on coal-fired power, and the prices of electricity are determined by the government, which increases the need for reform to enhance efficiency. In response to disputes about China’s electricity market reform, this paper analyses the efficiency of China’s coal-fired power plants using the Data Envelopment Analysis—Slack Based Measure (DEA-SBM) method on three levels: groups, provinces, and plants. The results indicate that there are both coal-electricity efficiency disparities and generation-hour arrangement unfairness across groups; the disparity across provinces is obvious and long-lasting, as indicated by capacity surpluses and coal-electricity efficiencies; and the disparities are displayed in detail by the estimation at the plant level. The disparities are primarily caused by the generator combination and generation hour arrangement. Competition may be able to solve the disparities, but a further comparison indicates that competition at the national level will enhance the efficiency to a greater degree than competition at the regional level. These results demonstrate that both competition and a united electricity market are necessary for further electricity market reform. - Highlights: • This paper analyses the coal-fired electricity efficiency from three levels. • There are efficiency disparities and hour arrangement unfairness at group level. • The disparities and unfairness are long-lasting across provinces. • The disparities and unfairness are detailed by analysis at plant level. • Competition at national market can improve the efficiency better than at regional market

Catching Up or Falling Behind? Continuing Wealth Disparities for Immigrants to Canada by Region of Origin and Cohort.

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Maroto, Michelle; Aylsworth, Laura

2016-11-01

This paper investigates wealth disparities among first-generation immigrants using data from the 2012 Survey of Financial Security. We apply logistic and linear regression models to estimate disparities in homeownership and household equivalent net worth by immigrant status, region of origin, and time since arrival. By focusing on immigrant families from different regions who entered Canada at different points in time, this research applies theories related to assimilation, human capital, and structural barriers to wealth. Our findings demonstrate that even though many immigrant families transition into homeownership and grow their wealth over time, certain first-generation immigrant groups continue to experience wealth disparities many years after their arrival to Canada. In particular, immigrant families from African, Asian, and Middle Eastern countries experienced the largest wealth gaps. Cet article examine les disparités de richesse entre les immigrants de première génération en utilisant les données de l'Enquête 2012 sur la sécurité financière. Nous appliquons des modèles de régression logistique et linéaire pour estimer les disparités dans la propriété et valeur nette des ménages équivalente par le statut d'immigrant, la région d'origine, et le temps écoulé depuis leur arrivée. En se concentrant sur les familles d'immigrants de différentes régions qui sont entrés au Canada à différents points dans le temps, cette recherche applique les théories liées à l'assimilation, le capital humain, et les obstacles structurels à la richesse. Nos résultats démontrent que même si de nombreuses familles d'immigrants transition vers la propriété et de croître leur richesse au fil du temps, certains groupes d'immigrants de première génération continuent d'éprouver des disparités de richesse de nombreuses années après leur arrivée au Canada. En particulier, les familles d'immigrants d'Afrique, d'Asie, et les pays du Moyen-Orient ont

Musculoskeletal networks reveal topological disparity in mammalian neck evolution.

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Arnold, Patrick; Esteve-Altava, Borja; Fischer, Martin S

2017-12-13

The increase in locomotor and metabolic performance during mammalian evolution was accompanied by the limitation of the number of cervical vertebrae to only seven. In turn, nuchal muscles underwent a reorganization while forelimb muscles expanded into the neck region. As variation in the cervical spine is low, the variation in the arrangement of the neck muscles and their attachment sites (i.e., the variability of the neck's musculoskeletal organization) is thus proposed to be an important source of neck disparity across mammals. Anatomical network analysis provides a novel framework to study the organization of the anatomical arrangement, or connectivity pattern, of the bones and muscles that constitute the mammalian neck in an evolutionary context. Neck organization in mammals is characterized by a combination of conserved and highly variable network properties. We uncovered a conserved regionalization of the musculoskeletal organization of the neck into upper, mid and lower cervical modules. In contrast, there is a varying degree of complexity or specialization and of the integration of the pectoral elements. The musculoskeletal organization of the monotreme neck is distinctively different from that of therian mammals. Our findings reveal that the limited number of vertebrae in the mammalian neck does not result in a low musculoskeletal disparity when examined in an evolutionary context. However, this disparity evolved late in mammalian history in parallel with the radiation of certain lineages (e.g., cetartiodactyls, xenarthrans). Disparity is further facilitated by the enhanced incorporation of forelimb muscles into the neck and their variability in attachment sites.

Why should we investigate the morphological disparity of plant clades?

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Oyston, Jack W; Hughes, Martin; Gerber, Sylvain; Wills, Matthew A

2016-04-01

Disparity refers to the morphological variation in a sample of taxa, and is distinct from diversity or taxonomic richness. Diversity and disparity are fundamentally decoupled; many groups attain high levels of disparity early in their evolution, while diversity is still comparatively low. Diversity may subsequently increase even in the face of static or declining disparity by increasingly fine sub-division of morphological 'design' space (morphospace). Many animal clades reached high levels of disparity early in their evolution, but there have been few comparable studies of plant clades, despite their profound ecological and evolutionary importance. This study offers a prospective and some preliminary macroevolutionary analyses. Classical morphometric methods are most suitable when there is reasonable conservation of form, but lose traction where morphological differences become greater (e.g. in comparisons across higher taxa). Discrete character matrices offer one means to compare a greater diversity of forms. This study explores morphospaces derived from eight discrete data sets for major plant clades, and discusses their macroevolutionary implications. Most of the plant clades in this study show initial, high levels of disparity that approach or attain the maximum levels reached subsequently. These plant clades are characterized by an initial phase of evolution during which most regions of their empirical morphospaces are colonized. Angiosperms, palms, pines and ferns show remarkably little variation in disparity through time. Conifers furnish the most marked exception, appearing at relatively low disparity in the latest Carboniferous, before expanding incrementally with the radiation of successive, tightly clustered constituent sub-clades. Many cladistic data sets can be repurposed for investigating the morphological disparity of plant clades through time, and offer insights that are complementary to more focused morphometric studies. The unique structural and

Cancer Disparities - Cancer Currents Blog

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Blog posts on cancer health disparities research—including factors that influence disparities, disparities-related research efforts, and diversity in the cancer research workforce—from NCI Cancer Currents.

The potential of low-intensity and online interventions for depression in low- and middle-income countries

NARCIS (Netherlands)

Bockting, C. L. H.; Williams, A. D.; Carswell, K.; Grech, A. E.

The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care

Ethnic and Racial Disparities in Education: Psychology's Role in Understanding and Reducing Disparities

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Quintana, Stephen M.; Mahgoub, Lana

2016-01-01

We review the scope and sources of ethnic and racial disparities in education with a focus on the the implications of psychological theory and research for understanding and redressing these disparities. We identify 3 sources of ethnic and racial disparities including (a) social class differences, (b) differential treatment based on ethnic and…

KETIMPANGAN PENDAPATAN ANTAR KABUPATEN/KOTA dan PERTUMBUHAN EKONOMI di PROPINSI JAWA TIMUR

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Denny Iswanto

2016-01-01

Full Text Available This research purposes are to analyse the intra-regional disparity and economic growth In East Java's region, the potential sectors to be developed, and to classify regions and sector in East Java based on its economic growth and per capita income. Methods that being used are economic growth analysis, Location Quotient (LQ, Shift-share, Sectoral Typology, Williamson Index, Theil Index, Pearson Correllation and Kusnetz hypothesis. The number of disadvantaged area in East Java also has to be addressed, which has reached 23 regions. Intra-regional economic disparity in 2008-2012 is above 0.5 (0,4295 and continously increasing. Meanwhile, Kuznets 'U' curve, which interpret the relationship between economic growth and disparity, is proven as unapplicable in East Java (sig-2 tailed correlation 0,160 with Williamson index and 0,257 Theil index. Recommendation to minimize the intra-regional income disparity in East Java is to apply the policy to put the disadvantaged region as the priority for the development. Potential sectors which has been the main sector for each regions are is necessary to be developed with innovation and technologyDOI: 10.15408/sjie.v4i1.2293

Rural Disparities in Treatment-Related Financial Hardship and Adherence to Surveillance Colonoscopy in Diverse Colorectal Cancer Survivors.

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McDougall, Jean A; Banegas, Matthew P; Wiggins, Charles L; Chiu, Vi K; Rajput, Ashwani; Kinney, Anita Y

2018-03-28

Cancer survivors increasingly report financial hardship as a consequence of the high cost of cancer care, yet the financial experience of rural cancer survivors remains largely unstudied. The purpose of this study was to investigate potential rural disparities in the likelihood of financial hardship and nonadherence to surveillance colonoscopy. Individuals diagnosed with localized or regional colorectal cancer (CRC) between 2004-2012 were ascertained by the population-based New Mexico Tumor Registry. Participants completed a mailed questionnaire or telephone survey about their CRC survivorship experience, including treatment-related financial hardship and receipt of surveillance colonoscopy. Multivariable logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). Compared to urban CRC survivors (n=168), rural CRC survivors (n=109) were slightly older, more likely to be married (65% v. 59%) and have an annual income financial hardship (OR 1.86, 95% CI 1.06-3.28) and nonadherence to surveillance colonoscopy guidelines (OR 2.28, 95% CI 1.07-4.85). In addition, financial hardship was independently associated with nonadherence to surveillance colonoscopy (OR 2.17, 95% CI 1.01-4.85). Substantial rural disparities in the likelihood of financial hardship and nonadherence to surveillance colonoscopy exist. Treatment-related financial hardship among rural CRC survivors may negatively impact adherence to guideline recommended follow-up care. Copyright ©2018, American Association for Cancer Research.

Race, Age, and Neighborhood Socioeconomic Status in Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry.

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Coley, Sheryl L; Nichols, Tracy R

2016-01-01

Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers. Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial status, age, and neighborhood socioeconomic status (as defined by census-tract median household income) and low birth weight outcomes across census tracts. Significant racial differences were identified in which African-American adolescents had greater odds of low birth weight outcomes than Caucasian adolescents (OR=1.88, 95% CI 1.64, 2.15). Although racial disparities in low birth weight outcomes remained significant in context of maternal age and neighborhood socioeconomic status, the greatest disparities were found between African-American and Caucasian adolescents that lived in areas of higher socioeconomic status (psocioeconomic status. Further investigations using intersectional frameworks are needed for examining the relationships between neighborhood socioeconomic status and birth outcome disparities among infants born to adolescent mothers.

Can school income and racial/ethnic composition explain the racial/ethnic disparity in adolescent physical activity participation?

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Richmond, Tracy K; Hayward, Rodney A; Gahagan, Sheila; Field, Alison E; Heisler, Michele

2006-06-01

Our goal was to determine if racial/ethnic disparities in adolescent boys' and girls' physical activity participation exist and persist once the school attended is considered. We performed a cross-sectional analysis of 17,007 teens in the National Longitudinal Study of Adolescent Health. Using multivariate linear regression, we examined the association between adolescent self-reported physical activity and individual race/ethnicity stratified by gender, controlling for a wide range of sociodemographic, attitudinal, behavioral, and health factors. We used multilevel analyses to determine if the relationship between race/ethnicity and physical activity varied by the school attended. Participants attended racially segregated schools; approximately 80% of Hispanic and black adolescent boys and girls attended schools with student populations that were schools that were >94% white. Black and Hispanic adolescent girls reported lower levels of physical activity than white adolescent girls. There were more similar levels of physical activity reported in adolescent boys, with black boys reporting slightly more activities. Although black and Hispanic adolescent girls were more likely to attend poorer schools with overall lower levels of physical activity in girls; there was no difference within schools between black, white, and Hispanic adolescent girls' physical activity levels. Within the same schools, both black and Hispanic adolescent boys had higher rates of physical activity when compared with white adolescent boys. In this nationally representative sample, lower physical activity levels in Hispanic and black adolescent girls were largely attributable to the schools they attended. In contrast, black and Hispanic males had higher activity levels than white males when attending the same schools. Future research is needed to determine the mechanisms through which school environments contribute to racial/ethnic disparities in adolescent physical activity and will need to

Examining the Gap: Compensation Disparities between Male and Female Physician Assistants.

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Smith, Noël; Cawley, James F; McCall, Timothy C

Compensation disparities between men and women have been problematic for decades, and there is considerable evidence that the gap cannot be entirely explained by nongender factors. The current study examined the compensation gap in the physician assistant (PA) profession. Compensation data from 2014 was collected by the American Academy of PAs in 2015. Practice variables, including experience, specialty, and hours worked, were controlled for in an ordinary least-squares sequential regression model to examine whether there remained a disparity in total compensation. In addition, the absolute disparity in compensation was compared with historical data collected by American Academy of PAs over the previous 1.5 decades. Without controlling for practice variables, a total compensation disparity of $16,052 existed between men and women in the PA profession. Even after PA practice variables were controlled for, a total compensation disparity of $9,695 remained between men and women (95% confidence interval, $8,438-$10,952). A 17-year trend indicates the absolute disparity between men and women has not lessened, although the disparity as a percent of male compensation has decreased in recent years. There remain challenges to ensuring pay equality in the PA profession. Even when compensation-relevant factors such as experience, hours worked, specialty, postgraduate training, region, and call are controlled for, there is still a substantial gender disparity in PA compensation. Remedies that may address this pay inequality include raising awareness of compensation disparities, teaching effective negotiation skills, assisting employers as they develop equitable compensation plans, having less reliance on past salary in position negotiation, and professional associations advocating for policies that support equal wages and opportunities, regardless of personal characteristics. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Ethnic disparities in access to care in post-apartheid South Africa.

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Kon, Zeida R; Lackan, Nuha

2008-12-01

We investigated ethnic disparities in obtaining medical care among the 4 major ethnic groups (Blacks, Whites, Coloreds [i.e., those of mixed race], and Asians) in post-apartheid South Africa. Data for the study came from the 2002 Afrobarometer: Round II Survey of South Africa. Bivariate and multivariate analyses were used to examine differences across racial and ethnic groups in how often respondents went without medical care. A total of 40.8% of Blacks and 22.9% of Coloreds reported going without medical care at some point in the past year, compared with 10.9% of Whites and 6.9% of Asians. Disparities were found not only in health but in education, income, and basic public health infrastructures. Sociodemographic characteristics and perceptions regarding democracy, markets, and civil society were similar for Blacks and Coloreds and for Whites and Asians. Fourteen years after the end of apartheid, Blacks and Coloreds in South Africa are still underserved and disadvantaged compared with their White and Asian counterparts, especially regarding health care.

Vertical binocular disparity is encoded implicitly within a model neuronal population tuned to horizontal disparity and orientation.

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Jenny C A Read

2010-04-01

Full Text Available Primary visual cortex is often viewed as a "cyclopean retina", performing the initial encoding of binocular disparities between left and right images. Because the eyes are set apart horizontally in the head, binocular disparities are predominantly horizontal. Yet, especially in the visual periphery, a range of non-zero vertical disparities do occur and can influence perception. It has therefore been assumed that primary visual cortex must contain neurons tuned to a range of vertical disparities. Here, I show that this is not necessarily the case. Many disparity-selective neurons are most sensitive to changes in disparity orthogonal to their preferred orientation. That is, the disparity tuning surfaces, mapping their response to different two-dimensional (2D disparities, are elongated along the cell's preferred orientation. Because of this, even if a neuron's optimal 2D disparity has zero vertical component, the neuron will still respond best to a non-zero vertical disparity when probed with a sub-optimal horizontal disparity. This property can be used to decode 2D disparity, even allowing for realistic levels of neuronal noise. Even if all V1 neurons at a particular retinotopic location are tuned to the expected vertical disparity there (for example, zero at the fovea, the brain could still decode the magnitude and sign of departures from that expected value. This provides an intriguing counter-example to the common wisdom that, in order for a neuronal population to encode a quantity, its members must be tuned to a range of values of that quantity. It demonstrates that populations of disparity-selective neurons encode much richer information than previously appreciated. It suggests a possible strategy for the brain to extract rarely-occurring stimulus values, while concentrating neuronal resources on the most commonly-occurring situations.

Disparities in eye care utilization among the United States adults with visual impairment: findings from the behavioral risk factor surveillance system 2006-2009.

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Chou, Chiu-Fang; Barker, Lawrence E; Crews, John E; Primo, Susan A; Zhang, Xinzhi; Elliott, Amanda F; McKeever Bullard, Kai; Geiss, Linda S; Saaddine, Jinan B

2012-12-01

To estimate the prevalence of annual eye care among visually impaired United States residents aged 40 years or older, by state, race/ethnicity, education, and annual income. Cross-sectional study. In analyses of 2006-2009 Behavioral Risk Factor Surveillance System data from 21 states, we used multivariate regression to estimate the state-level prevalence of yearly eye doctor visit in the study population by race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and other), annual income (≥$35,000 and education ( high school). The age-adjusted state-level prevalence of yearly eye doctor visits ranged from 48% (Missouri) to 69% (Maryland). In Alabama, Colorado, Indiana, Iowa, New Mexico, and North Carolina, the prevalence was significantly higher among respondents with more than a high school education than among those with a high school education or less (P education, and income, we also found significant disparities in the prevalence of yearly eye doctor visits among states. Among visually impaired US residents aged 40 or older, the prevalence of yearly eye examinations varied significantly by race/ethnicity, income, and education, both overall and within states. Continued and possibly enhanced collection of eye care utilization data, such as we analyzed here, may help states address disparities in vision health and identify population groups most in need of intervention programs. Copyright © 2012 Elsevier Inc. All rights reserved.

Exploring the Relation between the Degree of Novelty of Innovations and User-producer Interaction across Different Income Regions

DEFF Research Database (Denmark)

Harirchi, Gouya; Chaminade, Cristina

2014-01-01

User–producer interactions have been recognized as important for innovation. With the rapid growth of emerging economies’ markets, and an increasing degree of technological sophistication of both users and producers in those markets, user–producer interaction is becoming global. Using original firm......-level data, this paper explores how collaboration with users in different income regions affects the degree of innovations’ novelty. We find that collaborating with international users is positively related to higher degrees of novelty. Furthermore, firms in low- and middle income countries will benefit more...... from south–south user collaboration than a south–north one....

Conjunctions between motion and disparity are encoded with the same spatial resolution as disparity alone.

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Allenmark, Fredrik; Read, Jenny C A

2012-10-10

Neurons in cortical area MT respond well to transparent streaming motion in distinct depth planes, such as caused by observer self-motion, but do not contain subregions excited by opposite directions of motion. We therefore predicted that spatial resolution for transparent motion/disparity conjunctions would be limited by the size of MT receptive fields, just as spatial resolution for disparity is limited by the much smaller receptive fields found in primary visual cortex, V1. We measured this using a novel "joint motion/disparity grating," on which human observers detected motion/disparity conjunctions in transparent random-dot patterns containing dots streaming in opposite directions on two depth planes. Surprisingly, observers showed the same spatial resolution for these as for pure disparity gratings. We estimate the limiting receptive field diameter at 11 arcmin, similar to V1 and much smaller than MT. Higher internal noise for detecting joint motion/disparity produces a slightly lower high-frequency cutoff of 2.5 cycles per degree (cpd) versus 3.3 cpd for disparity. This suggests that information on motion/disparity conjunctions is available in the population activity of V1 and that this information can be decoded for perception even when it is invisible to neurons in MT.

Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level

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Lu, Chunling; Black, Maureen M; Richter, Linda M

2018-01-01

Summary Background A 2007 study published in The Lancet estimated that approximately 219 million children aged younger than 5 years were exposed to stunting or extreme poverty in 2004. We updated the 2004 estimates with the use of improved data and methods and generated estimates for 2010. Methods We used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, we excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, we also used moderate poverty measures. Findings The 2007 study underestimated children at risk of poor development. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279·1 million (95% CI 250·4 million–307·4 million) in 2004 to 249·4 million (209·3 million–292·6 million) in 2010; prevalence of children at risk fell from 51% (95% CI 46–56) to 43% (36–51). The decline occurred in all income groups and regions with south Asia experiencing the largest drop. Sub-Saharan Africa had the highest prevalence in both years. These findings were robust to variations in poverty measures. Interpretation Progress has been made in reducing the number of children exposed to stunting or poverty between 2004 and 2010, but this is still not enough. Scaling up of effective interventions targeting the most vulnerable children is urgently needed. Funding National Institutes of Health, Bill & Melinda Gates Foundation, Hilton Foundation, and WHO. PMID:27717632

Inequality, income, and poverty: comparative global evidence.

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Fosu, Augustin Kwasi

2010-01-01

Objectives. The study seeks to provide comparative global evidence on the role of income inequality, relative to income growth, in poverty reduction.Methods. An analysis-of-covariance model is estimated using a large global sample of 1980–2004 unbalanced panel data, with the headcount measure of poverty as the dependent variable, and the Gini coefficient and PPP-adjusted mean income as explanatory variables. Both random-effects and fixed-effects methods are employed in the estimation.Results. The responsiveness of poverty to income is a decreasing function of inequality, and the inequality elasticity of poverty is actually larger than the income elasticity of poverty. Furthermore, there is a large variation across regions (and countries) in the relative effects of inequality on poverty.Conclusion. Income distribution plays a more important role than might be traditionally acknowledged in poverty reduction, though this importance varies widely across regions and countries.

Chinese Gini Coefficient from 2005 to 2012, Based on 20 Grouped Income Data Sets of Urban and Rural Residents

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Jiandong Chen

2015-01-01

Full Text Available Data insufficiency has become the primary factor affecting research on income disparity in China. To resolve this issue, this paper explores Chinese income distribution and income inequality using distribution functions. First, it examines 20 sets of grouped data on family income between 2005 and 2012 by the China Yearbook of Household Surveys, 2013, and compares the fitting effects of eight distribution functions. The results show that the generalized beta distribution of the second kind has a high fitting to the income distribution of urban and rural residents in China. Next, these results are used to calculate the Chinese Gini ratio, which is then compared with the findings of relevant studies. Finally, this paper discusses the influence of urbanization on income inequality in China and suggests that accelerating urbanization can play an important role in narrowing the income gap of Chinese residents.

REGIONAL DISPARITIES IN SLOVAK REPUBLIC AT NUTS 3 LEVEL FROM DIRECT FOREIGN INVESTMENTS POINT OF VIEW

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Radoslav Koziak

2011-01-01

Full Text Available Slovak Republic, likewise other member states of the European Union, has beenexperiencing problems with the inter-regional differences for long time. These aremanifested in different forms (economic, social, environmental and others. Diversemacroeconomic regional indicators are used to express and quantificate the inter-regionaldifferences. Among traditionally used and by experts acknowledged quantities ofmeasurement of the inter-regional differences belong for example a gross domestic product(from diverse viewpoint and specification, labor market indicators, e.g. employment andunemployment rates, demographic development indicators, indicators assessingenvironment condition or standard of life, as well as the indicators quantifying theinvestments condition and development (domestic or foreign that flow into the objectterritory since we consider them an important factor and precondition of growth anddevelopment of the state as a whole, as well as its individual regions.The present contribution deals with an issue of the inter-regional differences formulationand measurement in the Slovak Republic on a NUTS 3 regions examination level (from anuniform system of the territorial units classification viewpoint, it means the autonomousdistricts (from a territorial-administrative order of Slovak Republic viewpoint, from directforeign investments‘ point of view.In the contribution there are theoretically defined basic concepts with which we operate,a specified methodological procedure for the inter-regional differences formulation andmeasurement, a direct foreign investments condition analysis from 1997 to 2007(development of the direct foreign investments during above period in all autonomousdistricts were subjected to a statistical examination as well as statistical testing that willreveal a convergence (meaning a moderation/decrease or a divergence (meaninga deepening of the inter-regional disparities on the NUTS 3 level. In addition to anabsolute

Healthcare disparities in critical illness.

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Soto, Graciela J; Martin, Greg S; Gong, Michelle Ng

2013-12-01

To summarize the current literature on racial and gender disparities in critical care and the mechanisms underlying these disparities in the course of acute critical illness. MEDLINE search on the published literature addressing racial, ethnic, or gender disparities in acute critical illness, such as sepsis, acute lung injury, pneumonia, venous thromboembolism, and cardiac arrest. Clinical studies that evaluated general critically ill patient populations in the United States as well as specific critical care conditions were reviewed with a focus on studies evaluating factors and contributors to health disparities. Study findings are presented according to their association with the prevalence, clinical presentation, management, and outcomes in acute critical illness. This review presents potential contributors for racial and gender disparities related to genetic susceptibility, comorbidities, preventive health services, socioeconomic factors, cultural differences, and access to care. The data are organized along the course of acute critical illness. The literature to date shows that disparities in critical care are most likely multifactorial involving individual, community, and hospital-level factors at several points in the continuum of acute critical illness. The data presented identify potential targets as interventions to reduce disparities in critical care and future avenues for research.

Household income, income inequality, and health-related quality of life measured by the EQ-5D in Shaanxi, China: a cross-sectional study.

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Tan, Zhijun; Shi, Fuyan; Zhang, Haiyue; Li, Ning; Xu, Yongyong; Liang, Ying

2018-03-14

In advanced economies, economic factors have been found to be associated with many health outcomes, including health-related quality of life (HRQL), and people's health is affected more by income inequality than by absolute income. However, few studies have examined the association of income inequality and absolute income with HRQL in transitional economies using individual data. This paper focuses on the effects of county or district income inequality and absolute income on the HRQL measured by EQ-5D and the differences between rural and urban regions in Shaanxi province, China. Data were collected from the 2008 National Health Service Survey conducted in Shaanxi, China. The EQ-5D index based on Japanese weights was employed as a health indicator. The income inequality was calculated on the basis of self-reported income. The special requirements for complex survey data analysis were considered in the bivariate analysis and linear regression models. The mean of the EQ-5D index was 94.6. The EQ-5D index of people with low income was lower than that in the high-income group (for people in the rural region: 93.2 v 96.1, P gender, education, marital status, employment, medical insurance, and chronic disease, all the coefficients of the low-income group and high income inequality were significantly negative. After stratifying by income group, all the effects of high income inequality remained negative in both income groups. However, the coefficients of the models in the high income group were not statistically significant. Income inequality has damaging effects on HRQL in Shaanxi, China, especially for people with low income. In addition, people living in rural regions were more vulnerable to economic factors.

Education, Income, and Employment and Prevalence of Chronic Disease Among American Indian/Alaska Native Elders.

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Adamsen, Collette; Schroeder, Shawnda; LeMire, Steven; Carter, Paula

2018-03-22

Chronic disease studies have omitted analyses of the American Indian/Alaska Native (AI/AN) population, relied on small samples of AI/ANs, or focused on a single disease among AI/ANs. We measured the influence of income, employment status, and education level on the prevalence of chronic disease among 14,632 AI/AN elders from 2011 through 2014. We conducted a national survey of AI/AN elders (≥55 y) to identify health and social needs. Using these data, we computed cross-tabulations for each independent variable (annual personal income, employment status, education level), 2 covariates (age, sex), and presence of any chronic disease. We also compared differences in values and used a binary logistic regression model to control for age and sex. Most AI/AN elders (89.7%) had been diagnosed with at least one chronic disease. AI/AN elders were also more than twice as likely to have diabetes and more likely to have arthritis. AI/AN elders with middle-to-low income levels and who were unemployed were more likely to have a chronic disease than were high-income and employed AI/AN elders. Addressing disparities in chronic disease prevalence requires focus on more than access to and cost of health care. Economic development and job creation for all age cohorts in tribal communities may decrease the prevalence of long-term chronic diseases and may improve the financial status of the tribe. An opportunity exists to address health disparities through social and economic equity among tribal populations.

What Are Cancer Disparities?

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This infographic shows the factors associated with cancer disparities, examples of how the cancer burden differs across certain population groups, and NCI actions to understand and reduce cancer disparities.

Successful schools and risky behaviors among low-income adolescents.

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Wong, Mitchell D; Coller, Karen M; Dudovitz, Rebecca N; Kennedy, David P; Buddin, Richard; Shapiro, Martin F; Kataoka, Sheryl H; Brown, Arleen F; Tseng, Chi-Hong; Bergman, Peter; Chung, Paul J

2014-08-01

We examined whether exposure to high-performing schools reduces the rates of risky health behaviors among low-income minority adolescents and whether this is due to better academic performance, peer influence, or other factors. By using a natural experimental study design, we used the random admissions lottery into high-performing public charter high schools in low-income Los Angeles neighborhoods to determine whether exposure to successful school environments leads to fewer risky (eg, alcohol, tobacco, drug use, unprotected sex) and very risky health behaviors (e.g., binge drinking, substance use at school, risky sex, gang participation). We surveyed 521 ninth- through twelfth-grade students who were offered admission through a random lottery (intervention group) and 409 students who were not offered admission (control group) about their health behaviors and obtained their state-standardized test scores. The intervention and control groups had similar demographic characteristics and eighth-grade test scores. Being offered admission to a high-performing school (intervention effect) led to improved math (P performance of public schools in low-income communities may be a powerful mechanism to decrease very risky health behaviors among low-income adolescents and to decrease health disparities across the life span. Copyright © 2014 by the American Academy of Pediatrics.

The influence of vertical disparity gradient and cue conflict on EEG omega complexity in Panum's limiting case.

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Li, Huayun; Jia, Huibin; Yu, Dongchuan

2018-03-01

Using behavioral measures and ERP technique, researchers discovered at least two factors could influence the final perception of depth in Panum's limiting case, which are the vertical disparity gradient and the degree of cue conflict between two- and three-dimensional shapes. Although certain event-related potential components have been proved to be sensitive to the different levels of these two factors, some methodological limitations existed in this technique. In this study, we proposed that the omega complexity of EEG signal may serve as an important supplement of the traditional event-related potential technique. We found that the trials with lower vertical gradient disparity have lower omega complexity (i.e., higher global functional connectivity) of the occipital region, especially that of the right-occipital hemisphere. Moreover, for occipital omega complexity, the trials with low-cue conflict have significantly larger omega complexity than those with medium- and high-cue conflict. It is also found that the electrodes located in the middle line of the occipital region (i.e., POz and Oz) are more crucial to the impact of different levels of cue conflict on omega complexity than the other electrodes located in the left- and right-occipital hemispheres. These evidences demonstrated that the EEG omega complexity could reflect distinct neural activities evoked by Panum's limiting case configurations, with different levels of vertical disparity gradient and cue conflict. Besides, the influence of vertical disparity gradient and cue conflict on omega complexity may be regional dependent. NEW & NOTEWORTHY The EEG omega complexity could reflect distinct neural activities evoked by Panum's limiting case configurations with different levels of vertical disparity gradient and cue conflict. The influence of vertical disparity gradient and cue conflict on omega complexity is regional dependent. The omega complexity of EEG signal can serve as an important supplement of the

Social disadvantage and the black-white disparity in spontaneous preterm delivery among California births.

Directory of Open Access Journals (Sweden)

Suzan L Carmichael

Full Text Available We examined the contribution of social disadvantage to the black-white disparity in preterm birth. Analyses included linked vital and hospital discharge records from 127,358 black and 615,721 white singleton California births from 2007-11. Odds ratios (OR were estimated by 4 logistic regression models for 2 outcomes: early (<32 wks and moderate (32-36 wks spontaneous preterm birth (ePTB, mPTB, stratified by 2 race-ethnicity groups (blacks and whites. We then conducted a potential impact analysis. The OR for less than high school education (vs. college degree was 1.8 (95% confidence interval 1.6, 2.1 for ePTB among whites but smaller for the other 3 outcome groups (ORs 1.3-1.4. For all 4 groups, higher census tract poverty was associated with increased odds (ORs 1.03-1.05 per 9% change in poverty. Associations were less noteworthy for the other variables (payer, and tract percent black and Gini index of income inequality. Setting 3 factors (education, poverty, payer to 'favorable' values was associated with lower predicted probability of ePTB (25% lower among blacks, 31% among whites but a 9% higher disparity, compared to probabilities based on observed values; for mPTB, respective percentages were 28% and 13% lower probability, and 17% lower disparity. Results suggest that social determinants contribute to preterm delivery and its disparities, and that future studies should focus on ePTB and more specific factors related to social circumstances.

The moral problem of health disparities.

Science.gov (United States)

Jones, Cynthia M

2010-04-01

Health disparities exist along lines of race/ethnicity and socioeconomic class in US society. I argue that we should work to eliminate these health disparities because their existence is a moral wrong that needs to be addressed. Health disparities are morally wrong because they exemplify historical injustices. Contractarian ethics, Kantian ethics, and utilitarian ethics all provide theoretical justification for viewing health disparities as a moral wrong, as do several ethical principles of primary importance in bioethics. The moral consequences of health disparities are also troubling and further support the claim that these disparities are a moral wrong. The Universal Declaration of Human Rights provides additional support that health disparities are a moral wrong, as does an analogy with the generally accepted duty to provide equal access to education. In this article, I also consider and respond to 3 objections to my thesis.

Mapping Medicare Disparities Tool

Data.gov (United States)

U.S. Department of Health & Human Services — The CMS Office of Minority Health has designed an interactive map, the Mapping Medicare Disparities Tool, to identify areas of disparities between subgroups of...

Unequal Depression for Equal Work? How the wage gap explains gendered disparities in mood disorders

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Platt, Jonathan; Prins, Seth; Bates, Lisa; Keyes, Katherine

2016-01-01

Mood disorders, such as depression and anxiety, are more prevalent among women than men. This disparity may be partially due to the effects of structural gender discrimination in the work force, which acts to perpetuate gender differences in opportunities and resources and may manifest as the gender wage gap. We sought to quantify and operationalize the wage gap in order to explain the gender disparity in depression and anxiety disorders, using data from a 2001–2002 US nationally representative survey of 22,581 working adults ages 30–65. Using established Oaxaca-Blinder decomposition methods to account for gender differences in individual-level productivity, our models reduced the wage gap in our sample by 13.5%, from 54% of men’s pay to 67.5% of men’s pay. We created a propensity-score matched sample of productivity indicators to test if the direction of the wage gap moderated the effects of gender on depression or anxiety. Where female income was less than the matched male counterpart, odds of both disorders were significantly higher among women versus men (major depressive disorder OR: 2.43, 95% CI: 1.95–3.04; generalized anxiety disorder OR: 4.11, 95% CI: 2.80–6.02). Where female income was greater than the matched male, the higher odds ratios for women for both disorders were significantly attenuated (Major Depressive Disorder OR: 1.20; 95% CI: 0.96–1.52) (Generalized Anxiety Disorder OR: 1.5; 95% CI: 1.04–2.29). The test for effect modification by sex and wage gap direction was statistically significant for both disorders. Structural forms of discrimination may explain mental health disparities at the population level. Beyond prohibiting overt gender discrimination, policies must be created to address embedded inequalities in procedures surrounding labor markets and compensation in the workplace. PMID:26689629

Unequal depression for equal work? How the wage gap explains gendered disparities in mood disorders.

Science.gov (United States)

Platt, Jonathan; Prins, Seth; Bates, Lisa; Keyes, Katherine

2016-01-01

Mood disorders, such as depression and anxiety, are more prevalent among women than men. This disparity may be partially due to the effects of structural gender discrimination in the work force, which acts to perpetuate gender differences in opportunities and resources and may manifest as the gender wage gap. We sought to quantify and operationalize the wage gap in order to explain the gender disparity in depression and anxiety disorders, using data from a 2001-2002 US nationally representative survey of 22,581 working adults ages 30-65. Using established Oaxaca-Blinder decomposition methods to account for gender differences in individual-level productivity, our models reduced the wage gap in our sample by 13.5%, from 54% of men's pay to 67.5% of men's pay. We created a propensity-score matched sample of productivity indicators to test if the direction of the wage gap moderated the effects of gender on depression or anxiety. Where female income was less than the matched male counterpart, odds of both disorders were significantly higher among women versus men (major depressive disorder OR: 2.43, 95% CI: 1.95-3.04; generalized anxiety disorder OR: 4.11, 95% CI: 2.80-6.02). Where female income was greater than the matched male, the higher odds ratios for women for both disorders were significantly attenuated (Major Depressive Disorder OR: 1.20; 95% CI: 0.96-1.52) (Generalized Anxiety Disorder OR: 1.5; 95% CI: 1.04-2.29). The test for effect modification by sex and wage gap direction was statistically significant for both disorders. Structural forms of discrimination may explain mental health disparities at the population level. Beyond prohibiting overt gender discrimination, policies must be created to address embedded inequalities in procedures surrounding labor markets and compensation in the workplace. Copyright © 2015 Elsevier Ltd. All rights reserved.

Race, Neighborhood Economic Status, Income Inequality and Mortality.

Directory of Open Access Journals (Sweden)

Nicolle A Mode

Full Text Available Mortality rates in the United States vary based on race, individual economic status and neighborhood. Correlations among these variables in most urban areas have limited what conclusions can be drawn from existing research. Our study employs a unique factorial design of race, sex, age and individual poverty status, measuring time to death as an objective measure of health, and including both neighborhood economic status and income inequality for a sample of middle-aged urban-dwelling adults (N = 3675. At enrollment, African American and White participants lived in 46 unique census tracts in Baltimore, Maryland, which varied in neighborhood economic status and degree of income inequality. A Cox regression model for 9-year mortality identified a three-way interaction among sex, race and individual poverty status (p = 0.03, with African American men living below poverty having the highest mortality. Neighborhood economic status, whether measured by a composite index or simply median household income, was negatively associated with overall mortality (p<0.001. Neighborhood income inequality was associated with mortality through an interaction with individual poverty status (p = 0.04. While racial and economic disparities in mortality are well known, this study suggests that several social conditions associated with health may unequally affect African American men in poverty in the United States. Beyond these individual factors are the influences of neighborhood economic status and income inequality, which may be affected by a history of residential segregation. The significant association of neighborhood economic status and income inequality with mortality beyond the synergistic combination of sex, race and individual poverty status suggests the long-term importance of small area influence on overall mortality.

Regional Disparities in the Beneficial Effects of Rising CO2 Emissions on Crop Water Productivity

Science.gov (United States)

Deryng, Delphine; Elliott, Joshua; Folberth, Christian; Meuller, Christoph; Pugh, Thomas A. M.; Boote, Kenneth J.; Conway, Declan; Ruane, Alex C.; Gerten, Dieter; Jones, James W.;

The Influence of Regional Social Inequality and Labour Market Characteristics on Health

Directory of Open Access Journals (Sweden)

Christiane Gross

2013-09-01

Full Text Available The influence of contextual factors on individual health status has been demonstrated by a number of studies even when controlling for the individual socio-economic situation (and other relevant factors. The article examines whether and to what extent variables of the place of residence have an effect on individual health status. We do not only refer to income levels and inequality, but also to effects of the educational level and inequality and the regional unemployment rate. As data basis for the individual level, we use the 2006 wave of the German Socio-Economic Panel Study (SOEP and add regional information on the aggregate level based on the regional units (Raumordnungsregionen of the Microcensus of 2005. These data will be analysed using multilevel models. The results reveal that regional educational inequality intensifies the individual educational effect, whereby members of less-educated groups in educationally disparate regions exhibit particularly low health chances. In addition, a high regional unemployment rate intensifies the negative effect of individual unemployment on men’s health.

Individual- and area-level disparities in access to the road network, subway system and a public bicycle share program on the Island of Montreal, Canada.

Science.gov (United States)

Fuller, Daniel; Gauvin, Lise; Kestens, Yan

2013-02-01

Few studies have examined potential disparities in access to transportation infrastructures, an important determinant of population health. To examine individual- and area-level disparities in access to the road network, public transportation system, and a public bicycle share program in Montreal, Canada. Examining associations between sociodemographic variables and access to the road network, public transportation system, and a public bicycle share program, 6,495 adult respondents (mean age, 48.7 years; 59.0 % female) nested in 33 areas were included in a multilevel analysis. Individuals with lower incomes lived significantly closer to public transportation and the bicycle share program. At the area level, the interaction between low-education and low-income neighborhoods showed that these areas were significantly closer to public transportation and the bicycle share program controlling for individual and urbanicity variables. More deprived areas of the Island of Montreal have better access to transportation infrastructure than less-deprived areas.

Neighborhood income inequality, social capital and emotional distress among adolescents: A population-based study.

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Vilhjalmsdottir, Arndis; Gardarsdottir, Ragna B; Bernburg, Jon Gunnar; Sigfusdottir, Inga Dora

2016-08-01

Theory holds that income inequality may harm adolescent mental health by reducing social capital within neighborhood communities. However, research on this topic has been very limited. We use multilevel data on 102 public schools and 5958 adolescents in Iceland (15 and 16 years old) to examine whether income inequality within neighborhoods is associated with emotional distress in adolescents. Moreover, we test whether indicators of social capital, including social trust and embeddedness in neighborhood social networks, mediate this contextual effect. The findings show that neighborhood income inequality positively influences emotional distress of individual adolescents, net of their personal household situations and social relations. However, although the indicators of social capital negatively influence emotional distress, they do not mediate the contextual effect of neighborhood income inequality. The study illustrates the role of economic disparities in adolescent mental health, but calls for more research on the underlying social and social-psychological mechanisms. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Population-based cancer screening programmes in low-income and middle-income countries: regional consultation of the International Cancer Screening Network in India.

Science.gov (United States)

Sivaram, Sudha; Majumdar, Gautam; Perin, Douglas; Nessa, Ashrafun; Broeders, Mireille; Lynge, Elsebeth; Saraiya, Mona; Segnan, Nereo; Sankaranarayanan, Rengaswamy; Rajaraman, Preetha; Trimble, Edward; Taplin, Stephen; Rath, G K; Mehrotra, Ravi

2018-02-01

The reductions in cancer morbidity and mortality afforded by population-based cancer screening programmes have led many low-income and middle-income countries to consider the implementation of national screening programmes in the public sector. Screening at the population level, when planned and organised, can greatly benefit the population, whilst disorganised screening can increase costs and reduce benefits. The International Cancer Screening Network (ICSN) was created to share lessons, experience, and evidence regarding cancer screening in countries with organised screening programmes. Organised screening programmes provide screening to an identifiable target population and use multidisciplinary delivery teams, coordinated clinical oversight committees, and regular review by a multidisciplinary evaluation board to maximise benefit to the target population. In this Series paper, we report outcomes of the first regional consultation of the ICSN held in Agartala, India (Sept 5-7, 2016), which included discussions from cancer screening programmes from Denmark, the Netherlands, USA, and Bangladesh. We outline six essential elements of population-based cancer screening programmes, and share recommendations from the meeting that policy makers might want to consider before implementation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Disparities in Chronic Conditions Among Women Hospitalized for Delivery in the United States, 2005-2014.

Science.gov (United States)

Admon, Lindsay K; Winkelman, Tyler N A; Moniz, Michelle H; Davis, Matthew M; Heisler, Michele; Dalton, Vanessa K

2017-12-01

To estimate trends in the prevalence and socioeconomic distribution of chronic conditions among women hospitalized for obstetric delivery in the United States. A retrospective, serial cross-sectional analysis was conducted using 2005-2014 data from the National Inpatient Sample. We estimated the prevalence of eight common, chronic conditions, each associated with obstetric morbidity and mortality, among all childbearing women and then across socioeconomic predictors of obstetric outcomes. Differences over time were measured and compared across rural and urban residence, income, and payer subgroups for each condition. We identified 8,193,707 delivery hospitalizations, representing 39,273,417 delivery hospitalizations occurring nationally between 2005 and 2014. Identification of at least one chronic condition increased significantly between 2005-2006 and 2013-2014 (66.9 per 1,000 delivery hospitalizations in 2005-2006 compared with 91.8 per 1,000 delivery hospitalizations in 2013-2014). The prevalence of multiple chronic conditions also increased during the study period, from 4.7 (95% CI 4.2-5.2) to 8.1 (95% CI 7.8-8.4) per 1,000 delivery hospitalizations between 2005-2006 and 2013-2014. Chronic respiratory disease, chronic hypertension, substance use disorders, and pre-existing diabetes were the disorders with the greatest increases in prevalence over time. Increasing disparities over time were identified across all socioeconomic subgroups analyzed including rural compared with urban residence, income, and payer. Key areas of concern include the rate at which substance use disorders rose among rural women and the disproportionate burden of each condition among women from the lowest income communities and among women with Medicaid as their primary payer. Between 2005-2006 and 2013-2014, the prevalence of chronic conditions increased across all segments of the childbearing population. Widening disparities were identified over time with key areas of concern including

The relation between household income and surgical outcome in the Dutch setting of equal access to and provision of healthcare.

Science.gov (United States)

Ultee, Klaas H J; Tjeertes, Elke K M; Bastos Gonçalves, Frederico; Rouwet, Ellen V; Hoofwijk, Anton G M; Stolker, Robert Jan; Verhagen, Hence J M; Hoeks, Sanne E

2018-01-01

The impact of socioeconomic disparities on surgical outcome in the absence of healthcare inequality remains unclear. Therefore, we set out to determine the association between socioeconomic status (SES), reflected by household income, and overall survival after surgery in the Dutch setting of equal access and provision of care. Additionally, we aim to assess whether SES is associated with cause-specific survival and major 30-day complications. Patients undergoing surgery between March 2005 and December 2006 in a general teaching hospital in the Netherlands were prospectively included. Adjusted logistic and cox regression analyses were used to assess the independent association of SES-quantified by gross household income-with major 30-day complications and long-term postoperative survival. A total of 3929 patients were included, with a median follow-up of 6.3 years. Low household income was associated with worse survival in continuous analysis (HR: 1.05 per 10.000 euro decrease in income, 95% CI: 1.01-1.10) and in income quartile analysis (HR: 1.58, 95% CI: 1.08-2.31, first [i.e. lowest] quartile relative to the fourth quartile). Similarly, low income patients were at higher risk of cardiovascular death (HR: 1.26 per 10.000 decrease in income, 95% CI: 1.07-1.48, first income quartile: HR: 3.10, 95% CI: 1.04-9.22). Household income was not independently associated with cancer-related mortality and major 30-day complications. Low SES, quantified by gross household income, is associated with increased overall and cardiovascular mortality risks among surgical patients. Considering the equality of care provided by this study setting, the associated survival hazards can be attributed to patient and provider factors, rather than disparities in healthcare. Increased physician awareness of SES as a risk factor in preoperative decision-making and focus on improving established SES-related risk factors may improve surgical outcome of low SES patients.

City Level of Income and Urbanization and Availability of Food Stores and Food Service Places in China.

Science.gov (United States)

Liao, Chunxiao; Tan, Yayun; Wu, Chaoqun; Wang, Shengfeng; Yu, Canqing; Cao, Weihua; Gao, Wenjing; Lv, Jun; Li, Liming

2016-01-01

The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. The findings suggested food environment disparities did exist in different cities of China.

City Level of Income and Urbanization and Availability of Food Stores and Food Service Places in China.

Directory of Open Access Journals (Sweden)

Chunxiao Liao

Full Text Available The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization.The cross-sectional survey was comprised of two parts: (1 an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2 an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models.Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas.The findings suggested food environment disparities did exist in different cities of China.

City Level of Income and Urbanization and Availability of Food Stores and Food Service Places in China

Science.gov (United States)

Liao, Chunxiao; Tan, Yayun; Wu, Chaoqun; Wang, Shengfeng; Yu, Canqing; Cao, Weihua; Gao, Wenjing; Lv, Jun; Li, Liming

2016-01-01

Objective The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. Methods The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. Results Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. Conclusions The findings suggested food environment disparities did exist in different cities of China. PMID:26938866

Disparities in perceived patient-provider communication quality in the United States: Trends and correlates.

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Spooner, Kiara K; Salemi, Jason L; Salihu, Hamisu M; Zoorob, Roger J

2016-05-01

This study aimed to describe disparities and temporal trends in the level of perceived patient-provider communication quality (PPPCQ) in the United States, and to identify sociodemographic and health-related factors associated with elements of PPPCQ. A cross-sectional analysis was conducted using nationally-representative data from the 2011-2013 iterations of the Health Information National Trends Survey (HINTS). Descriptive statistics, multivariable linear and logistic regression analyses were conducted to examine associations. PPPCQ scores, the composite measure of patients' ratings of communication quality, were positive overall (82.8; 95% CI: 82.1-83.5). However, less than half (42-46%) of respondents perceived that providers always addressed their feelings, spent enough time with them, or helped with feelings of uncertainty about their health. Older adults and those with a regular provider consistently had higher PPPCQ scores, while those with poorer perceived general health were consistently less likely to have positive perceptions of their providers' communication behaviors. Disparities in PPPCQ can be attributed to patients' age, race/ethnicity, educational attainment, employment status, income, healthcare access and general health. These findings may inform educational and policy efforts which aim to improve patient-provider communication, enhance the quality of care, and reduce health disparities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Universal or Commodified Healthcare? Linking Out-of-Pocket Payments to Income-Related Inequalities in Unmet Health Needs in Europe

DEFF Research Database (Denmark)

Kaminska, Monika Ewa; Wulfgramm, Melike

2018-01-01

This study investigates the outcomes out-of-pocket payments (OOPP) produce in terms of income-related disparities in unmet health needs (UHN) due to inability to pay and highlights the commodifying effect of OOPP in European healthcare systems. It merges micro data from the European Union...

Socioeconomic inequities in the health and nutrition of children in low/middle income countries

OpenAIRE

Barros, Fernando C; Victora, Cesar G; Scherpbier, Robert; Gwatkin, Davidson

2010-01-01

OBJECTIVE: To describe the effects of social inequities on the health and nutrition of children in low and middle income countries. METHODS: We reviewed existing data on socioeconomic disparities within-countries relative to the use of services, nutritional status, morbidity, and mortality. A conceptual framework including five major hierarchical categories affecting inequities was adopted: socioeconomic context and position, differential exposure, differential vulnerability, differential hea...

Rural/Urban Disparities in Science Achievement in Post-Socialist Countries: The Evolving Influence of Socioeconomic Status

Science.gov (United States)

Kryst, Erica L.; Kotok, Stephen; Bodovski, Katerina

2015-01-01

Disparities in educational outcomes exist between students in rural areas as compared to students in urban settings. While there is some evidence that these rural disparities are present in eastern Europe, little is known about young peoples' lives in the rural areas of this region. This paper presents an analysis of science achievement by…

Inter-Regional Spillovers and Urban-Rural Disparity in U.S. Employment Growth

OpenAIRE

Hisamitsu Saito; Munisamy Gopinath; JunJie Wu

2011-01-01

A wide urban-rural disparity is observed in employment growth in the United States. For example, employment growth averaged 2.1 percent in urban counties during 1998-2007, compared with just 1 percent in rural counties. In this study, we examine the sources of U.S. employment growth using the county-level industry data. From an analytical labor-market model, we derive equilibrium employment growth as a function of growth in neighborhood characteristics and initial conditions such as accumulat...

Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level.

Science.gov (United States)

Lu, Chunling; Black, Maureen M; Richter, Linda M

2016-12-01

A 2007 study published in The Lancet estimated that approximately 219 million children aged younger than 5 years were exposed to stunting or extreme poverty in 2004. We updated the 2004 estimates with the use of improved data and methods and generated estimates for 2010. We used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, we excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, we also used moderate poverty measures. The 2007 study underestimated children at risk of poor development. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279·1 million (95% CI 250·4 million-307·4 million) in 2004 to 249·4 million (209·3 million-292·6 million) in 2010; prevalence of children at risk fell from 51% (95% CI 46-56) to 43% (36-51). The decline occurred in all income groups and regions with south Asia experiencing the largest drop. Sub-Saharan Africa had the highest prevalence in both years. These findings were robust to variations in poverty measures. Progress has been made in reducing the number of children exposed to stunting or poverty between 2004 and 2010, but this is still not enough. Scaling up of effective interventions targeting the most vulnerable children is urgently needed. National Institutes of Health, Bill & Melinda Gates Foundation, Hilton Foundation, and WHO. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license. Published by Elsevier Ltd.. All rights reserved.

Spatial and Inter-temporal Sources of Poverty, Inequality and Gender Disparities in Cameroon: a Regression-Based Decomposition Analysis

OpenAIRE

Boniface Ngah Epo; Francis Menjo Baye; Nadine Teme Angele Manga

2011-01-01

This study applies the regression-based inequality decomposition technique to explain poverty and inequality trends in Cameroon. We also identify gender related factors which explain income disparities and discrimination based on the 2001 and 2007 Cameroon household consumption surveys. The results show that education, health, employment in the formal sector, age cohorts, household size, gender, ownership of farmland and urban versus rural residence explain household economic wellbeing; dispa...

Do the Preferences of Healthcare Provider Selection Vary among Rural and Urban Patients with Different Income and Cause Different Outcome?

Directory of Open Access Journals (Sweden)

Tsung-Hsien Yu

Full Text Available Equal access to healthcare facilities and high-level quality of care are important strategies to eliminate the disparity in outcome of care. However, the existing literature regarding how urban or rural dwelling patients with different income level select healthcare providers is insufficient. The purposes of this study were to examine whether differences of healthcare provider selection exist among urban and rural coronary artery bypass surgery (CABG patients with different income level. If so, we further investigated the associated impact on mortality.A retrospective, multilevel study design was conducted using claims data from 2007-2011 Taiwan's Universal Health Insurance Scheme. Healthcare providers' performance and patients' travelling distance to hospitals were used to define the patterns of healthcare provider selection. Baron and Kenny's procedures for mediation effect were conducted.There were 10,108 CABG surgeries included in this study. The results showed that urban dwelling and higher income patients were prone to receive care from better-performance providers. The travelling distances of urban dwelling patients was 15 KM shorter, especially when they received better-performance provider's care. The results also showed that the difference of healthcare provider selection and mortality rate existed between rural and urban dwelling patients with different income levels. After the procedure of mediation effect testing, the results showed that the healthcare provider selection partially mediated the relationships between patients' residential areas with different income levels and 30-day mortality.Preferences of healthcare provider selection vary among rural and urban patients with different income, and such differences partially mediated the outcome of care. Health authorities should pay attention to this issue, and propose appropriate solutions to eliminate the disparity in outcome of CABG care.

Do the Preferences of Healthcare Provider Selection Vary among Rural and Urban Patients with Different Income and Cause Different Outcome?

Science.gov (United States)

Yu, Tsung-Hsien; Chung, Kuo-Piao; Wei, Chung-Jen; Chien, Kuo-Liong; Hou, Yu-Chang

2016-01-01

Equal access to healthcare facilities and high-level quality of care are important strategies to eliminate the disparity in outcome of care. However, the existing literature regarding how urban or rural dwelling patients with different income level select healthcare providers is insufficient. The purposes of this study were to examine whether differences of healthcare provider selection exist among urban and rural coronary artery bypass surgery (CABG) patients with different income level. If so, we further investigated the associated impact on mortality. A retrospective, multilevel study design was conducted using claims data from 2007-2011 Taiwan's Universal Health Insurance Scheme. Healthcare providers' performance and patients' travelling distance to hospitals were used to define the patterns of healthcare provider selection. Baron and Kenny's procedures for mediation effect were conducted. There were 10,108 CABG surgeries included in this study. The results showed that urban dwelling and higher income patients were prone to receive care from better-performance providers. The travelling distances of urban dwelling patients was 15 KM shorter, especially when they received better-performance provider's care. The results also showed that the difference of healthcare provider selection and mortality rate existed between rural and urban dwelling patients with different income levels. After the procedure of mediation effect testing, the results showed that the healthcare provider selection partially mediated the relationships between patients' residential areas with different income levels and 30-day mortality. Preferences of healthcare provider selection vary among rural and urban patients with different income, and such differences partially mediated the outcome of care. Health authorities should pay attention to this issue, and propose appropriate solutions to eliminate the disparity in outcome of CABG care.

The association between income inequality and all-cause mortality across urban communities in Korea.

Science.gov (United States)

Park, Jong; Ryu, So-Yeon; Han, Mi-ah; Choi, Seong-Woo

2015-06-20

Korea has achieved considerable economic growth more rapidly than most other countries, but disparities in income level have increased. Therefore, we sought to assess the association between income inequality and mortality across Korean cities. Data on household income were obtained from the 2010-2012 Korean Community Health Survey and data on all-cause mortality and other covariates were obtained from the Korean Statistical Information Service. The Gini coefficient, Robin Hood index, and income share ratio between the 80th and 20th percentiles of the distribution were measured for each community. After excluding communities affected by changes in administrative districts between 2010 and 2012, a total of 157 communities and 172,398 urban residents were included in the analysis. When we graphed income inequality measures versus all-cause mortality as scatter plots, the R square values of the regression lines for GC, RHI, and 80/20 ratios relative to mortality were 0.230, 0.238, and 0.152, respectively. After adjusting for other covariates and median household income, mean all-cause mortality increased significantly with increasing GC (P for trend = 0.014) and RHI (P for trend = 0.031), and increased marginally with 80/20 ratio (P for trend = 0.067). Our data demonstrate that income inequality measures are significantly associated with all-cause mortality rate after adjustment for covariates, including median household income across urban communities in Korea.

Poverty targeting and income impact of subsidised credit on accessed households in the Northern Mountainous Region of Vietnam

Directory of Open Access Journals (Sweden)

Do Xuan Luan

2015-10-01

Full Text Available This paper uses the data of 1338 rural households in the Northern Mountainous Region of Vietnam to examine the extent to which subsidised credit targets the poor and its impacts. Principal Component Analysis and Propensity Score Matching were used to evaluate the depth of outreach and the income impact of credit. To address the problem of model uncertainty, the approach of Bayesian Model Average applied to the probit model was used. Results showed that subsidised credit successfully targeted the poor households with 24.10% and 69.20% of clients falling into the poorest group and the three bottom groups respectively. Moreover, those who received subsidised credit make up 83% of ethnic minority households. These results indicate that governmental subsidies are necessary to reach the poor and low income households, who need capital but are normally bypassed by commercial banks. Analyses also showed that ethnicity and age of household heads, number of helpers, savings, as well as how affected households are by shocks were all factors that further explained the probability at which subsidised credit has been assessed. Furthermore, recipients obtained a 2.61% higher total income and a 5.93% higher farm income compared to non-recipients. However, these small magnitudes of effects are statistically insignificant at a 5% level. Although the subsidised credit is insufficient to significantly improve the income of the poor households, it possibly prevents these households of becoming even poorer.

Disparities in trauma: the impact of socioeconomic factors on outcomes following traumatic hollow viscus injury.

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Hazlitt, Melissa; Hill, J Bradford; Gunter, Oliver L; Guillamondegui, Oscar D

2014-09-01

This piece aims to examine the relationships between hollow viscus injury (HVI) and socioeconomic factors in determining outcomes. HVI has well-defined injury patterns with complex postoperative convalescence and morbidity, representing an ideal focus for identifying potential disparities among a homogeneous injury population. A retrospective review included patients admitted to a level I trauma center with HVI from 2000-2009, as identified in the Trauma Registry of the American College of Surgeons. Patients with concomitant significant solid organ or vasculature injury were excluded. US Census (2000) median household income by zip code was used as socioeconomic proxy. Demographic and injury-related variables were also included. Endpoints were mortality and outcomes associated with HVI morbidity. A total of 933 patients with HVI were identified and 256 met inclusion criteria. There were 23 deaths (9.0%), and mortality was not associated with race, gender, income, or payer source. However, lower median household income was significantly associated with longer intervals to ostomy takedown (P = 0.032). Additionally, private payers had significantly lower rates of anastomotic leak (0% [0/73] versus 7.1% [13/183], P = 0.019) and fascial dehiscence (5.5% [4/73] versus 16.9% [31/183], P = 0.016), while self-payers had significantly higher rates of abscess formation, both overall (24% [24/100] versus 10.2% [16/156], P = 0.004) and among penetrating injuries (27.4% [23/84] versus 13.6% [12/88], P = 0.036). Socioeconomic status may not impact overall mortality among trauma patients with hollow viscus injuries, but private insurance appears to be protective of morbidity related to anastomotic leak, fascial dehiscence, and abscess formation. This supports that socioeconomic disparity may exist within long-term outcomes, particularly regarding payer source. Copyright © 2014 Elsevier Inc. All rights reserved.

Income inequality and happiness: Is there a relationship?

OpenAIRE

Alois, Paul

2014-01-01

This paper uses fixed effects regressions to examine the relationship between happiness and income inequality in 30 countries. It has three major findings. First, happiness and income inequality are correlated in the expected direction; high income inequality correlates with a smaller share of happy people and a higher share of unhappy people. Second, different regions have characteristics that strongly mediate the effect of income inequality on happiness. Third, the correlation between incom...

Climacteric complaints among very low-income women from a tropical region of Brazil

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Sebastião Freitas de Medeiros

Full Text Available CONTEXT AND OBJECTIVE: Climacteric symptoms may vary between different countries and cultures. Socioeconomic factors and climate may be implicated. The aim of this study was to identify climacteric symptomatology among very low-income Brazilian women, living in a hot and humid region. DESIGN AND SETTING: This cross-sectional population-based study was conducted in Cuiabá, at Júlio Müller University Hospital, a tertiary institution. METHODS: The study enrolled 354 climacteric women. The variables analyzed were social class, symptomatology and abnormal concurrent conditions. The study was approved by the hospital's research ethics committee. RESULTS: Sixty-five percent of the participants (232/354 were very poor and had had little schooling. The number of symptoms per woman was 8.0 ± 5.7. Hot flushes, nervousness, forgetfulness and fatigue were each found in nearly 60.0%. Tearfulness, depression, melancholy and insomnia were also frequent. Sexual problems were reported by 25%. The most relevant concurrent abnormal conditions reported were hypertension (33.9%, obesity (26.5%, arthritis/arthrosis (15.0% and diabetes mellitus (9.6%. Hot flushes were associated with tearfulness, nervousness and forgetfulness. CONCLUSION: Brazilian climacteric women of low income and low schooling present multiple symptoms. Vasomotor and psychosexual symptoms were the most prevalent disorders. Hot flushes were associated with nervousness, forgetfulness and tearfulness.

REGRESSIONAL ANALYSIS OF CONSUMER NUTRITION SPENDINGS IN THE HOUSEHOLDS OF THE REGION AS FUNCTION OF PERSONAL INCOME AND PRICE

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I. N. Siulzhyn

2017-01-01

Full Text Available The multiple regression analysis method is widely used to describe and investigate some processes of the regional economy and may be also used to solve an important problem of distinguishing the effects of various independent or partially dependent variables. The regression model considered includes the specification of its constituent relationships, the choice of variables included in each relation, and the definition of mathematical functions corresponding to these relations. Regression model of food expenditure with two independent variables - expenditure as a function of income and price is based upon the official quarterly averaged statistical information (2015 and 2016 years. All the data are presented in the interpolated monthly version. Regression analysis made it possible to specify the dependence of expenditure on food in the country's households on the disposable personal income and the relative price of foodstuffs, which must be taken into account when solving problems of the region's social and economic development.

Income, Family Context, and Self-Regulation in 5-Year-Old Children.

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Li, Mengying; Riis, Jenna L; Ghazarian, Sharon R; Johnson, Sara B

Self-regulation (SR) is a core aspect of child development with enduring effects on health and wellbeing across the lifespan. Early childhood poverty may shape SR development. This study examined the cross-sectional relationship among family income, family context, and SR in 5-year-old children. A total of 140 five-year-old children and their mothers participated in the study. Children completed a battery of SR tasks; mothers completed questionnaires. Cognitive and emotional SR composite scores were generated based on a principal component analysis of the SR tasks. The SR scores were first regressed on family income (in 10 levels ranging from family context variables were subsequently added to the models. Controlling for age, sex, and race, each level increase in family income was associated with 0.04 SD increase in emotional SR (p = .32) and 0.08 SD increase in cognitive SR (p = .01). In fully adjusted models, exposure to household instability and experiencing 10 or more negative life events was associated with worse emotional SR; exposure to mother's depressive symptoms was associated with worse cognitive SR. Higher income buffered children's SR from some contextual risk factors. Family contextual variables explained 62% of the correlation between higher income and better cognitive SR scores. Income-based cognitive SR disparities were associated with family contextual factors. Screening for family adversity in pediatric care and linking families to needed resources may protect children's developing SR capacities, with benefits to health and well-being.

Levels and trends in the income mobility of U.S. families, 1977 - 2012

OpenAIRE

Bradbury, Katharine L.

2016-01-01

Much of America's promise is predicated on economic mobility - the possibility that people can move up and down the economic ladder during their lifetimes. Mobility is of particular consequence when economic disparities are increasing. Using panel data and mobility concepts and measures adapted from the literature, this paper examines 10-year income mobility levels and trends for U.S. working-age families during the time span 1977 - 2012. According to many measures, mobility, already limited ...

Does health insurance mitigate inequities in non-communicable disease treatment? Evidence from 48 low- and middle-income countries.

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El-Sayed, Abdulrahman M; Palma, Anton; Freedman, Lynn P; Kruk, Margaret E

2015-09-01

Non-communicable diseases (NCDs) are the greatest contributor to morbidity and mortality in low- and middle-income countries (LMICs). However, NCD care is limited in LMICs, particularly among the disadvantaged and rural. We explored the role of insurance in mitigating socioeconomic and urban-rural disparities in NCD treatment across 48 LMICs included in the 2002-2004 World Health Survey (WHS). We analyzed data about ever having received treatment for diagnosed high-burden NCDs (any diagnosis, angina, asthma, depression, arthritis, schizophrenia, or diabetes) or having sold or borrowed to pay for healthcare. We fit multivariable regression models of each outcome by the interaction between insurance coverage and household wealth (richest 20% vs. poorest 50%) and urbanicity, respectively. We found that insurance was associated with higher treatment likelihood for NCDs in LMICs, and helped mitigate socioeconomic and regional disparities in treatment likelihood. These influences were particularly strong among women. Insurance also predicted lower likelihood of borrowing or selling to pay for health services among the poorest women. Taken together, insurance coverage may serve as an important policy tool in promoting NCD treatment and in reducing inequities in NCD treatment by household wealth, urbanicity, and sex in LMICs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Socioeconomic Disparities in Smoking Among U.S. Adults With Depression, 2005-2014.

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Weinberger, Andrea H; Bandiera, Frank C; Leventhal, Adam M; Dierker, Lisa C; Gbedemah, Misato; Tidey, Jennifer W; Goodwin, Renee D

2018-06-01

The purpose of this study is to estimate changes in the cigarette smoking prevalence among U.S. adults with and without depression from 2005 to 2014 by income and education level and overall. This study examined data from adult respondents (aged ≥18 years) in the National Survey on Drug Use and Health, an annual cross-sectional study of U.S. individuals. Data from the years 2005 to 2014 were analyzed for a total analytic sample of n=378,733. The prevalence of past-month cigarette smoking was examined annually from 2005 to 2014 among adults with and without past-year major depression, overall and by income/education, using linear trend analyses. Data analysis occurred in 2017. The prevalence of smoking declined significantly from 2005 to 2014 among those with depression (37.62% to 34.01%; p<0.001) and without depression (23.99% to 19.87%; p<0.001). Yet, smoking remained nearly twice as common among those with depression during this period. Among adults with depression in the lowest income and education groups, the prevalence of smoking was more than double the prevalence of smoking among adults with depression in the highest income and education groups. Disparities in smoking prevalence are pronounced when depression and SES are considered simultaneously. Targeted public health and clinical efforts to reduce smoking among adult smokers of lower SES with depression are needed. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Income, Amenities and Negative Attitudes

DEFF Research Database (Denmark)

Waisman, Gisela; Larsen, Birthe

2016-01-01

We exploit the regional variation in negative attitudes towards immigrants to Sweden in order to analyse the consequences of negative attitudes on refugees’ utility from labour income and amenities. We find that attitudes towards immigrants are important: while they affect mainly the refugees......’ quality of life, they also affect their income. We estimate the utility effects of negative attitudes for refugees with different levels of education and gender. We also analyse how the size of the refugees’ networks relate to their quality of life and income as well as how negative attitudes towards...

Lay Health Worker Involvement in Evidence-Based Treatment Delivery: A Conceptual Model to Address Disparities in Care.

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Barnett, Miya L; Lau, Anna S; Miranda, Jeanne

2018-05-07

Mobilizing lay health workers (LHWs) to deliver evidence-based treatments (EBTs) is a workforce strategy to address mental health disparities in underserved communities. LHWs can be leveraged to support access to EBTs in a variety of ways, from conducting outreach for EBTs delivered by professional providers to serving as the primary treatment providers. This critical review provides an overview of how LHW-supported or -delivered EBTs have been leveraged in low-, middle-, and high-income countries (HICs). We propose a conceptual model for LHWs to address drivers of service disparities, which relate to the overall supply of the EBTs provided and the demand for these treatments. The review provides illustrative case examples that demonstrate how LHWs have been leveraged globally and domestically to increase access to mental health services. It also discusses challenges and recommendations regarding implementing LHW-supported or -delivered EBTs.

What Aspects of Rural Life Contribute to Rural-Urban Health Disparities in Older Adults? Evidence From a National Survey.

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Cohen, Steven A; Cook, Sarah K; Sando, Trisha A; Sabik, Natalie J

2017-11-29

Rural-urban health disparities are well-documented and particularly problematic for older adults. However, determining which specific aspects of rural or urban living initiate these disparities remains unclear. The purpose of this study was to assess associations between place-based characteristics of rural-urban status and health among adults age 65+. Data from the 2012 Behavioral Risk Factor Surveillance System were geographically linked to place-based characteristics from the American Community Survey. Self-reported health (SRH), obesity, and health checkup within the last year were modeled against rural-urban status (distance to nearest metropolitan area, population size, population density, percent urban, Urban Influence Codes [UIC], Rural-Urban Continuum Codes [RUCC], and Rural-Urban Commuting Area [RUCA]) using generalized linear models, accounting for covariates and complex sampling, overall, and stratified by area-level income. In general, increasing urbanicity was associated with a reduction in negative SRH for all 7 measures of rural-urban status. For low-income counties, this association held for all measures and characteristics of rural-urban status except population density. However, for high-income counties, the association was reversed-respondents living in areas of increasing urbanicity were more likely to report negative SRH for 4 of the 7 measures (RUCC, UIC, RUCA, and percent urban). Findings were mixed for the outcome of obesity, where rural areas had higher levels, except in low-income counties, where the association between rurality and obesity was reversed (OR 1.033, 95%CI: 1.002-1.064). These results suggest that rural-urban status is both a continuum and multidimensional. Distinct elements of rural-urban status may influence health in nuanced ways that require additional exploration in future studies. © 2017 National Rural Health Association.

Where There's a Will: The Link Between Estate Planning and Disparities in Advance Care Planning by White and Black Older Adults.

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Koss, Catheryn S; Baker, Tamara A

2018-03-01

Data from the Health and Retirement Study ( n = 6,946) were used to test whether differences in estate planning accounted for disparities in advance care planning between White and Black older adults. White participants were more likely to have advance directives after controlling for demographic, health, and financial variables. When estate planning was also controlled, the odds of having an advance directive were equal for White and Black participants. In contrast, Whites remained more likely to discuss end-of-life preferences after controlling for demographic, health, financial, and estate planning variables. White participants were almost four times as likely to have wills or trusts. Wealth, income, and home ownership were predictive of estate planning. Financial disparities contributed to lower rates of estate planning which in turn explained in large part why Black older adults were less likely to have advance directives but did not account for race disparities in advance care discussion.

Race, Neighborhood Economic Status, Income Inequality and Mortality.

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Mode, Nicolle A; Evans, Michele K; Zonderman, Alan B

2016-01-01

Mortality rates in the United States vary based on race, individual economic status and neighborhood. Correlations among these variables in most urban areas have limited what conclusions can be drawn from existing research. Our study employs a unique factorial design of race, sex, age and individual poverty status, measuring time to death as an objective measure of health, and including both neighborhood economic status and income inequality for a sample of middle-aged urban-dwelling adults (N = 3675). At enrollment, African American and White participants lived in 46 unique census tracts in Baltimore, Maryland, which varied in neighborhood economic status and degree of income inequality. A Cox regression model for 9-year mortality identified a three-way interaction among sex, race and individual poverty status (p = 0.03), with African American men living below poverty having the highest mortality. Neighborhood economic status, whether measured by a composite index or simply median household income, was negatively associated with overall mortality (pinequality was associated with mortality through an interaction with individual poverty status (p = 0.04). While racial and economic disparities in mortality are well known, this study suggests that several social conditions associated with health may unequally affect African American men in poverty in the United States. Beyond these individual factors are the influences of neighborhood economic status and income inequality, which may be affected by a history of residential segregation. The significant association of neighborhood economic status and income inequality with mortality beyond the synergistic combination of sex, race and individual poverty status suggests the long-term importance of small area influence on overall mortality.

Disparities in Gynecological Malignancies

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Sudeshna eChatterjee

2016-02-01

Full Text Available Objectives: Health disparities and inequalities in access to care among different socioeconomic, ethnic, and racial groups have been well documented in the U.S. healthcare system. In this review, we aimed to provide an overview of barriers to care contributing to health disparities in gynecological oncology management and to describe site-specific disparities in gynecologic care for endometrial, ovarian, and cervical cancer. Methods: We performed a literature review of peer-reviewed academic and governmental publications focusing on disparities in gynecological care in the United States by searching PubMed and Google Scholar electronic databases. Results: There are multiple important underlying issues that may contribute to the disparities in gynecological oncology management in the United States, namely geographic access and hospital based-discrepancies, research-based discrepancies, influence of socioeconomic and health insurance status, and finally the influence of race and biological factors. Despite the reduction in overall cancer-related deaths since the 1990s, the 5-year survival for Black women is significantly lower than for White women for each gynecologic cancer type and each stage of diagnosis. For ovarian and endometrial cancer, black patients are less likely to receive treatment consistent with evidence-based guidelines and have worse survival outcomes even after accounting for stage and comorbidities. For cervical and endometrial cancer, the mortality rate for black women remains twice that of White women. Conclusions: Health care disparities in the incidence and outcome of gynecologic cancers are complex and involve biologic factors as well as racial, socioeconomic and geographic barriers that influence treatment and survival. These barriers must be addressed to provide optimal care to women in the U.S. with gynecologic cancer.

Comparative linkage meta-analysis reveals regionally-distinct, disparate genetic architectures: application to bipolar disorder and schizophrenia.

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Brady Tang

2011-04-01

Full Text Available New high-throughput, population-based methods and next-generation sequencing capabilities hold great promise in the quest for common and rare variant discovery and in the search for "missing heritability." However, the optimal analytic strategies for approaching such data are still actively debated, representing the latest rate-limiting step in genetic progress. Since it is likely a majority of common variants of modest effect have been identified through the application of tagSNP-based microarray platforms (i.e., GWAS, alternative approaches robust to detection of low-frequency (1-5% MAF and rare (<1% variants are of great importance. Of direct relevance, we have available an accumulated wealth of linkage data collected through traditional genetic methods over several decades, the full value of which has not been exhausted. To that end, we compare results from two different linkage meta-analysis methods--GSMA and MSP--applied to the same set of 13 bipolar disorder and 16 schizophrenia GWLS datasets. Interestingly, we find that the two methods implicate distinct, largely non-overlapping, genomic regions. Furthermore, based on the statistical methods themselves and our contextualization of these results within the larger genetic literatures, our findings suggest, for each disorder, distinct genetic architectures may reside within disparate genomic regions. Thus, comparative linkage meta-analysis (CLMA may be used to optimize low-frequency and rare variant discovery in the modern genomic era.

FDI, Human Capital and Income Convergence

DEFF Research Database (Denmark)

Völlmecke, Dominik; Jindra, Björn; Marek, Philipp

2016-01-01

within Central and East European countries (CEECs), where we find indications of a poverty trap. In contrast to FDI, regional human capital seems to be associated with higher income levels. However, we identify a positive interaction of FDI and human capital in their relation with income growth dynamics....

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

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

2017-12-01

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

Processing vertical size disparities in distinct depth planes.

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Duke, Philip A; Howard, Ian P

2012-08-17

A textured surface appears slanted about a vertical axis when the image in one eye is horizontally enlarged relative to the image in the other eye. The surface appears slanted in the opposite direction when the same image is vertically enlarged. Two superimposed textured surfaces with different horizontal size disparities appear as two surfaces that differ in slant. Superimposed textured surfaces with equal and opposite vertical size disparities appear as a single frontal surface. The vertical disparities are averaged. We investigated whether vertical size disparities are averaged across two superimposed textured surfaces in different depth planes or whether they induce distinct slants in the two depth planes. In Experiment 1, two superimposed textured surfaces with different vertical size disparities were presented in two depth planes defined by horizontal disparity. The surfaces induced distinct slants when the horizontal disparity was more than ±5 arcmin. Thus, vertical size disparities are not averaged over surfaces with different horizontal disparities. In Experiment 2 we confirmed that vertical size disparities are processed in surfaces away from the horopter, so the results of Experiment 1 cannot be explained by the processing of vertical size disparities in a fixated surface only. Together, these results show that vertical size disparities are processed separately in distinct depth planes. The results also suggest that vertical size disparities are not used to register slant globally by their effect on the registration of binocular direction of gaze.

Subjective and objective measurements of visual fatigue induced by excessive disparities in stereoscopic images

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Jung, Yong Ju; Kim, Dongchan; Sohn, Hosik; Lee, Seong-il; Park, Hyun Wook; Ro, Yong Man

2013-03-01

As stereoscopic displays have spread, it is important to know what really causes the visual fatigue and discomfort and what happens in the visual system in the brain behind the retina while viewing stereoscopic 3D images on the displays. In this study, functional magnetic resonance imaging (fMRI) was used for the objective measurement to assess the human brain regions involved in the processing of the stereoscopic stimuli with excessive disparities. Based on the subjective measurement results, we selected two subsets of comfort videos and discomfort videos in our dataset. Then, a fMRI experiment was conducted with the subsets of comfort and discomfort videos in order to identify which brain regions activated while viewing the discomfort videos in a stereoscopic display. We found that, when viewing a stereoscopic display, the right middle frontal gyrus, the right inferior frontal gyrus, the right intraparietal lobule, the right middle temporal gyrus, and the bilateral cuneus were significantly activated during the processing of excessive disparities, compared to those of small disparities (< 1 degree).

Determinants of geographic inequalities in HPV vaccination in the most populated region of France.

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Héquet, Delphine; Rouzier, Roman

2017-01-01

In France, there are recommendations and reimbursements for human papillomavirus (HPV) vaccination but no HPV vaccination programs. Therefore, vaccination is largely determined by parents' initiative, which can lead to inequalities. The objective of this study was to determine the factors associated with poorer vaccination coverage rates in the most populated region of France. The data of this study were obtained from the National Health Insurance between 2011 and 2013. Correlations between vaccination initiation rate (at least 1 dose reimbursed) and socio-demographic/cultural factors were assessed using Pearson's product-moment correlation coefficient. Multivariate analyses were performed using logistic regression. In total, 121,636 girls received at least one HPV vaccine dose. The vaccination rate for girls born from 1996 to 1999 was 18.7%. Disparities in vaccination coverage rates were observed between the 8 departments of the region, ranging from 12.9% to 22.6%. At the department level, unemployment, proportion of immigrants and foreigners, and coverage by CMU health insurance ("Couverture Maladie Universelle", a health insurance plan for those who are not otherwise covered through business or employment and who have a low income) were significantly inversely correlated with vaccination rates, whereas urban residence, medical density, income and use of medical services were not related to coverage. In the multivariate model, only the percentage of foreigners remained independently associated with lower vaccination coverage. At the individual level, the use of medical services was a strong driver of HPV vaccination initiation. We observed geographic disparities in HPV vaccination initiation coverage. Even if no clear factor was identified as a vaccination determinant, we observed a failure of vaccination only based on parents' initiative. Therefore, an organized policy on HPV vaccination, such as school-based programs, can help improve coverage rates.

Determinants of geographic inequalities in HPV vaccination in the most populated region of France.

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Delphine Héquet

Full Text Available In France, there are recommendations and reimbursements for human papillomavirus (HPV vaccination but no HPV vaccination programs. Therefore, vaccination is largely determined by parents' initiative, which can lead to inequalities. The objective of this study was to determine the factors associated with poorer vaccination coverage rates in the most populated region of France.The data of this study were obtained from the National Health Insurance between 2011 and 2013. Correlations between vaccination initiation rate (at least 1 dose reimbursed and socio-demographic/cultural factors were assessed using Pearson's product-moment correlation coefficient. Multivariate analyses were performed using logistic regression.In total, 121,636 girls received at least one HPV vaccine dose. The vaccination rate for girls born from 1996 to 1999 was 18.7%. Disparities in vaccination coverage rates were observed between the 8 departments of the region, ranging from 12.9% to 22.6%. At the department level, unemployment, proportion of immigrants and foreigners, and coverage by CMU health insurance ("Couverture Maladie Universelle", a health insurance plan for those who are not otherwise covered through business or employment and who have a low income were significantly inversely correlated with vaccination rates, whereas urban residence, medical density, income and use of medical services were not related to coverage. In the multivariate model, only the percentage of foreigners remained independently associated with lower vaccination coverage. At the individual level, the use of medical services was a strong driver of HPV vaccination initiation.We observed geographic disparities in HPV vaccination initiation coverage. Even if no clear factor was identified as a vaccination determinant, we observed a failure of vaccination only based on parents' initiative. Therefore, an organized policy on HPV vaccination, such as school-based programs, can help improve coverage

Minority Health and Health Disparities

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... ik People" People Awakening Resilience Project (PARP), Cuqyun "Measuring" Treatment and Health Services Research Alcohol Treatment and ... addressing Health Disparities . 1 2009-2013 Health Disparities Strategic Plan, p.4 2 Ibid, p.4 3 ...

Disparity and convergence: Chinese provincial government health expenditures.

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Pan, Jay; Wang, Peng; Qin, Xuezheng; Zhang, Shufang

2013-01-01

The huge regional disparity in government health expenditures (GHE) is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.

Disparity and convergence: Chinese provincial government health expenditures.

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Jay Pan

Full Text Available The huge regional disparity in government health expenditures (GHE is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.

Health-related quality-of-life in low-income, uninsured men with prostate cancer.

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Krupski, Tracey L; Fink, Arlene; Kwan, Lorna; Maliski, Sally; Connor, Sarah E; Clerkin, Barbara; Litwin, Mark S

2005-05-01

The objective was to describe health-related quality-of-life (HRQOL) in low-income men with prostate cancer. Subjects were drawn from a statewide public assistance prostate cancer program. Telephone and mail surveys included the RAND 12-item Health Survey and UCLA Prostate Cancer Index Short Form and were compared with normative age-matched men without cancer from the general population reported on in the literature. Of 286 eligible men, 233 (81%) agreed to participate and completed the necessary items. The sample consisted of 51% Hispanics, 23% non-Hispanic whites, and 17% African Americans. The low-income men had worse scores in every domain of prostate-specific and general HRQOL than had the age-matched general population controls. The degree of disparity indicated substantial clinical differences in almost every domain of physical and emotional functioning between the sample group and the control group. Linear regression modeling determined that among the low-income men, Hispanic race, and income level were predictive of worse physical functioning, whereas only comorbidities predicted mental health. Low-income patients with prostate cancer appear to have quality-of-life profiles that are meaningfully worse than age-matched men from the general population without cancer reported on in the literature.

Population changes, racial/ethnic disparities, and birth outcomes in Louisiana after Hurricane Katrina.

Science.gov (United States)

Harville, Emily W; Tran, Tri; Xiong, Xu; Buekens, Pierre

2010-09-01

To examine how the demographic and other population changes affected birth and obstetric outcomes in Louisiana, and the effect of the hurricane on racial disparities in these outcomes. Vital statistics data were used to compare the incidence of low birth weight (LBW) (birth (PTB) (37 weeks' gestation), cesarean section, and inadequate prenatal care (as measured by the Kotelchuck index), in the 2 years after Katrina compared to the 2 years before, for the state as a whole, region 1 (the area around New Orleans), and Orleans Parish (New Orleans). Logistic models were used to adjust for covariates. After adjustment, rates of LBW rose for the state, but preterm birth did not. In region 1 and Orleans Parish, rates of LBW and PTB remained constant or fell. These patterns were all strongest in African American women. Rates of cesarean section and inadequate prenatal care rose. Racial disparities in birth outcomes remained constant or were reduced. Although risk of LBW/PTB remained higher in African Americans, the storm does not appear to have exacerbated health disparities, nor did population shifts explain the changes in birth and obstetric outcomes.

The relationship of sociodemographic and psychological variables with chronic pain variables in a low-income population.

Science.gov (United States)

Newman, Andrea K; Van Dyke, Benjamin P; Torres, Calia A; Baxter, Jacob W; Eyer, Joshua C; Kapoor, Shweta; Thorn, Beverly E

2017-09-01

Chronic pain is a pervasive condition that is complicated by economic, educational, and racial disparities. This study analyzes key factors associated with chronic pain within an understudied and underserved population. The sample is characterized by a triple disparity with respect to income, education/literacy, and racial barriers that substantially increase the vulnerability to the negative consequences of chronic pain. The study examined the pretreatment data of 290 participants enrolled in the Learning About My Pain trial, a randomized controlled comparative effectiveness trial of psychosocial interventions (B.E.T., Principal Investigator, Patient-Centered Outcomes Research Institute Contract No. 941; clinicaltrials.gov identifier NCT01967342) for chronic pain. Hierarchical multiple regression analyses evaluated the relationships among sociodemographic (sex, age, race, poverty status, literacy, and education level) and psychological (depressive symptoms and pain catastrophizing) variables and pain interference, pain severity, and disability. The indirect effects of depressive symptoms and pain catastrophizing on the sociodemographic and pain variables were investigated using bootstrap resampling. Reversed mediation models were also examined. Results suggested that the experience of chronic pain within this low-income sample is better accounted for by psychological factors than sex, age, race, poverty status, literacy, and education level. Depressive symptoms and pain catastrophizing mediated the relationships between age and pain variables, whereas pain catastrophizing mediated the effects of primary literacy and poverty status. Some reversed models were equivalent to the hypothesized models, suggesting the possibility of bidirectionality. Although cross-sectional findings cannot establish causality, our results highlight the critical role psychological factors play in individuals with chronic pain and multiple health disparities.

Racial disparity in bacterial vaginosis: the role of socioeconomic status, psychosocial stress, and neighborhood characteristics, and possible implications for preterm birth.

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Paul, Kathleen; Boutain, Doris; Manhart, Lisa; Hitti, Jane

2008-09-01

Racial disparity in preterm birth is one of the most salient, yet least well-understood health disparities in the United States. The preterm birth disparity may be due to differences in how women experience their racial identity in light of neighborhood factors, psychosocial stress, or the prevalence of or response to genital tract infections such as bacterial vaginosis (BV). The latest research emphasizes a need to explore all these factors simultaneously. This cross-sectional study of parous women in King County, Washington, USA investigated the effects of household income, psychosocial stress, and neighborhood socioeconomic characteristics on risk of BV after accounting for known individual-level risk factors. Relevant demographic, socioeconomic, and medical data were linked to U.S. census socioeconomic data by geocoding subjects' residential addresses. It was found that having a low income was significantly associated with an increased prevalence of BV among African American but not White American women. A higher number of stressful life events was significantly associated with higher BV prevalence among both African American and White American women. However, perceived stress was not related to BV risk among either group of women. Among White American women, neighborhood socioeconomic status (SES) was univariately associated with increased BV prevalence by principal components analysis, but was no longer significant after adjusting for individual-level risk factors. No neighborhood SES effects were observed for African American women. These results suggest that both the effects of individual- and neighborhood-level risk factors for BV may differ importantly by racial group, and stressful life events may have physiological effects independent of perceived stress.

Health disparities in the immunoprevention of human papillomavirus infection and associated malignancies

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Amira eBakir

2015-12-01

Full Text Available Human papillomavirus (HPV causes about 1.6% of the roughly 1.6 million new cancer cases that are diagnosed in the United States each year. Despite the proven safety and efficacy of currently available vaccines, HPV remains the most common sexually transmitted infection. Underlying the high prevalence of HPV infection is the poor adherence to the Centers for Disease Control (CDC recommendation that all 11-12 year old males and females be vaccinated. In fact, only about 38% and 14% of eligible females and males respectively, receive the complete, three-dose immunization.Many factors are associated with missed HPV vaccination opportunities, including race, age, family income and patient education, resulting in widespread disparities in vaccination rates and related health outcomes. Beyond patient circumstance, however, research indicates that the rigor and consistency of recommendation by primary care providers also plays a significant role in uptake of HPV immunization. Health disparities data are of vital importance to HPV vaccination campaigns because they can provide insight into how to address current problems and allocate limited resources where they are most needed. Furthermore, even modest gains in populations with low vaccination rates may yield great benefits because HPV immunization has been shown to provide herd immunity, indirect protection for non-immunized individuals achieved by limiting the spread of an infectious agent through a population. HPV vaccination campaigns face the challenge of stagnant HPV immunization rates, which are increasing slowly overall but remain far below target levels. Furthermore, gains in immunization are not equal across all groups and vaccination rates are strikingly disparate across the federal poverty level. To achieve the greatest impact, public health campaigns should focus on improving vaccination coverage where it is weakest. In addition to demographics, socioeconomic factors and attitudes of

Regional disparities in the intimate partner sexual violence rate against women in Paraná State, Brazil, 2009-2014: an ecological study.

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Fontes, Kátia Biagio; Jacinto Alarcão, Ana Carolina; Nihei, Oscar Kenji; Pelloso, Sandra Marisa; Andrade, Luciano; Barros Carvalho, Maria Dalva de

2018-02-20

Evaluate disparities in a Brazilian state by conducting an analysis to determine whether socioeconomic status was associated with the reported intimate partner sexual violence (IPSV) rates against women. A retrospective, ecological study. Data retrieved from the Notifiable Diseases Information System database of the Ministry of Health of Brazil. All cases of IPSV (n=516) against women aged 15-49 years reported in the Notifiable Diseases Information System between 2009 and 2014. The data were evaluated through an exploratory analysis of spatial data. We identified a positive spatial self-correlation in the IPSV rate (0.7105, P≤0.001). Five high-high-type clusters were identified, predominantly in the Metropolitan, West, South Central, Southwest, Southeast and North Central mesoregions, with only one cluster identified in the North Pioneer mesoregion. Our findings also indicated that the associations between the IPSV rate and socioeconomic predictors (women with higher education, civil registry of legal separations, economically active women, demographic density and average female income) were significantly spatially non-stationary; thus, the regression coefficients verified that certain variables in the model were associated with the IPSV rate in some regions of the state. In addition, the geographically weighted regression (GWR) model improved the understanding of the associations between socioeconomic indicators and the IPSV notification rate, showing a better adjustment than the ordinary least square (OLS) model (OLS vs GWR model: R 2 : 0.95 vs 0.99; Akaike information criterion: 4117.90 vs 3550.61; Moran's I: 0.0905 vs -0.0273, respectively). IPSV against women was heterogeneous in the state of Paraná. The GWR model showed a better fit and enabled the analysis of the distribution of each indicator in the state, which demonstrated the utility of this model for the study of IPSV dynamics and the indication of local determinants of IPSV notification rates. �

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

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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.

Analysis of Income Inequality Based on Income Mobility for Poverty Alleviation in Rural China

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Tingting Li

2015-12-01

Full Text Available Since the reform and opening up, the Chinese economy has achieved sustained high-speed growth. However, the widening gaps in income, especially for rural China, seem to be a dark lining to these extraordinary achievements. Taking the duration of poverty into the consideration, this article analyzes the income inequality of rural per capita net income (RPCNI based on income mobility in rural China. Analysis results showed that Gini coefficient of RPCNI declined, but that income mobility was mainly limited in the interior for low- and high-income groups. Income inequalities rose sharply within eastern and western China from 1990 to 2010. Benefiting from the developed economy, the upward mobility was universal in eastern China. The spillover effect on neighboring poor counties was feeble in western China, which directly caused long-term rich and poor. The Gini coefficient of RPCNI in central China was always at a low level, corresponding to the phenomenon of short-term rich and long-term poor. In northeastern China, the Gini coefficient sharply decreased and the large body of income mobility between non-neighboring groups was quite remarkable. The spatial pattern of intra-provincial Gini coefficient and income mobility of RPCNI has been divided by the “HU line”, which is a “geo-demographic demarcation line” discovered by Chinese population geographer HU Huanyong in 1935. In southeastern China, the characteristics of income mobility of each county depended on the distance between the county and the capital city. The spatial pattern of income mobility of RPCNI in agricultural provinces was different from that in non-agricultural provinces. According to the income inequality and income mobility, appropriate welfare and development policies was proposed to combat rural poverty at both regional and provincial scales.

Impact of income inequality on life expectancy in a highly unequal developing country: the case of Brazil.

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Rasella, Davide; Aquino, Rosana; Barreto, Mauricio Lima

2013-08-01

Few studies have analysed the effects of income inequality on health in developing countries, particularly during economic growth, reduction of social disparities and reinforcement of the welfare and healthcare system. We evaluated the association between income inequality and life expectancy in Brazil, including the effect of social and health interventions, in the period 2000-2009. A panel dataset was created for the 27 Brazilian states over the referred time period. Multivariable linear regressions were performed using fixed-effects estimation with heteroscedasticity and serial correlation robust SEs. Models were fitted for life expectancy as a dependent variable, using the Gini index or a percentile income dispersion ratio as the main independent variable, and for demographic, socioeconomic and healthcare-related determinants as covariates. The Gini index, as the other measure of income inequality, was negatively associated with life expectancy (pincome inequality, contributing-together with PHC-to decreasing death rates in the population. Reducing income inequality may represent an important step towards improving health and increasing life expectancy, particularly in developing countries where inequalities are high.

Neighborhood Environment and Disparities in Health Care Access Among Urban Medicare Beneficiaries With Diabetes: A Retrospective Cohort Study.

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Ryvicker, Miriam; Sridharan, Sridevi

2018-01-01

Older adults' health is sensitive to variations in neighborhood environment, yet few studies have examined how neighborhood factors influence their health care access. This study examined whether neighborhood environmental factors help to explain racial and socioeconomic disparities in health care access and outcomes among urban older adults with diabetes. Data from 123 233 diabetic Medicare beneficiaries aged 65 years and older in New York City were geocoded to measures of neighborhood walkability, public transit access, and primary care supply. In 2008, 6.4% had no office-based "evaluation and management" (E&M) visits. Multilevel logistic regression indicated that this group had greater odds of preventable hospitalization in 2009 (odds ratio = 1.31; 95% confidence interval: 1.22-1.40). Nonwhites and low-income individuals had greater odds of a lapse in E&M visits and of preventable hospitalization. Neighborhood factors did not help to explain these disparities. Further research is needed on the mechanisms underlying these disparities and older adults' ability to navigate health care. Even in an insured population living in a provider-dense city, targeted interventions may be needed to overcome barriers to chronic illness care for older adults in the community.

Breast Cancer Screening Programmes across the WHO European Region: Differences among Countries Based on National Income Level.

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Altobelli, Emma; Rapacchietta, Leonardo; Angeletti, Paolo Matteo; Barbante, Luca; Profeta, Filippo Valerio; Fagnano, Roberto

2017-04-23

Breast cancer (BC) is the most frequent tumour affecting women all over the world. In low- and middle-income countries, where its incidence is expected to rise further, BC seems set to become a public health emergency. The aim of the present study is to provide a systematic review of current BC screening programmes in WHO European Region to identify possible patterns. Multiple correspondence analysis was performed to evaluate the association among: measures of occurrence; GNI level; type of BC screening programme; organization of public information and awareness campaigns regarding primary prevention of modifiable risk factors; type of BC screening services; year of screening institution; screening coverage and data quality. A key difference between High Income (HI) and Low and Middle Income (LMI) States, emerging from the present data, is that in the former screening programmes are well organized, with approved screening centres, the presence of mobile units to increase coverage, the offer of screening tests free of charge; the fairly high quality of occurrence data based on high-quality sources, and the adoption of accurate methods to estimate incidence and mortality. In conclusion, the governments of LMI countries should allocate sufficient resources to increase screening participation and they should improve the accuracy of incidence and mortality rates.

Counties eliminating racial disparities in colorectal cancer mortality.

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Rust, George; Zhang, Shun; Yu, Zhongyuan; Caplan, Lee; Jain, Sanjay; Ayer, Turgay; McRoy, Luceta; Levine, Robert S

2016-06-01

Although colorectal cancer (CRC) mortality rates are declining, racial-ethnic disparities in CRC mortality nationally are widening. Herein, the authors attempted to identify county-level variations in this pattern, and to characterize counties with improving disparity trends. The authors examined 20-year trends in US county-level black-white disparities in CRC age-adjusted mortality rates during the study period between 1989 and 2010. Using a mixed linear model, counties were grouped into mutually exclusive patterns of black-white racial disparity trends in age-adjusted CRC mortality across 20 three-year rolling average data points. County-level characteristics from census data and from the Area Health Resources File were normalized and entered into a principal component analysis. Multinomial logistic regression models were used to test the relation between these factors (clusters of related contextual variables) and the disparity trend pattern group for each county. Counties were grouped into 4 disparity trend pattern groups: 1) persistent disparity (parallel black and white trend lines); 2) diverging (widening disparity); 3) sustained equality; and 4) converging (moving from disparate outcomes toward equality). The initial principal component analysis clustered the 82 independent variables into a smaller number of components, 6 of which explained 47% of the county-level variation in disparity trend patterns. County-level variation in social determinants, health care workforce, and health systems all were found to contribute to variations in cancer mortality disparity trend patterns from 1990 through 2010. Counties sustaining equality over time or moving from disparities to equality in cancer mortality suggest that disparities are not inevitable, and provide hope that more communities can achieve optimal and equitable cancer outcomes for all. Cancer 2016;122:1735-48. © 2016 American Cancer Society. © 2016 American Cancer Society.

Health disparities among highly vulnerable populations in the United States: a call to action for medical and oral health care

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Allison A. Vanderbilt

2013-03-01

Full Text Available Healthcare in the United States (US is burdened with enormous healthcare disparities associated with a variety of factors including insurance status, income, and race. Highly vulnerable populations, classified as those with complex medical problems and/or social needs, are one of the fastest growing segments within the US. Over a decade ago, the US Surgeon General publically challenged the nation to realize the importance of oral health and its relationship to general health and well-being, yet oral health disparities continue to plague the US healthcare system. Interprofessional education and teamwork has been demonstrated to improve patient outcomes and provide benefits to participating health professionals. We propose the implementation of interprofessional education and teamwork as a solution to meet the increasing oral and systemic healthcare demands of highly vulnerable US populations.

Income Migration and Home Price Trajectories in the United States

OpenAIRE

Samuel M. Otterstrom

2015-01-01

This paper models one facet of the relationship between housing market price shifts and income migration among U.S. regions: how income migration relates to regional housing price clusters. The tremendous negative slide in national housing prices from 2006 to 2012 had an uneven spatial distribution. These differences are explored within the context of net income and net population migration (movement of money with people). Median housing prices for urban areas from 2005 to 2010 and IRS county...

Social disparities in food preparation behaviours: a DEDIPAC study.

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Méjean, Caroline; Si Hassen, Wendy; Gojard, Séverine; Ducrot, Pauline; Lampuré, Aurélie; Brug, Hans; Lien, Nanna; Nicolaou, Mary; Holdsworth, Michelle; Terragni, Laura; Hercberg, Serge; Castetbon, Katia

2017-09-20

The specific role of major socio-economic indicators in influencing food preparation behaviours could reveal distinct socio-economic patterns, thus enabling mechanisms to be understood that contribute to social inequalities in health. This study investigated whether there was an independent association of each socio-economic indicator (education, occupation, income) with food preparation behaviours. A total of 62,373 adults participating in the web-based NutriNet-Santé cohort study were included in our cross-sectional analyses. Cooking skills, preparation from scratch and kitchen equipment were assessed using a 0-10-point score; frequency of meal preparation, enjoyment of cooking and willingness to cook better/more frequently were categorical variables. Independent associations between socio-economic factors (education, income and occupation) and food preparation behaviours were assessed using analysis of covariance and logistic regression models stratified by sex. The models simultaneously included the three socio-economic indicators, adjusting for age, household composition and whether or not they were the main cook in the household. Participants with the lowest education, the lowest income group and female manual and office workers spent more time preparing food daily than participants with the highest education, those with the highest income and managerial staff (P cooks than those with the highest education level (Women: OR = 3.36 (1.69;6.69); Men: OR = 1.83 (1.07;3.16)) while female manual and office workers and the never-employed were less likely to be non-cooks (OR = 0.52 (0.28;0.97); OR = 0.30 (0.11;0.77)). Female manual and office workers had lower scores of preparation from scratch and were less likely to want to cook more frequently than managerial staff (P cooking meal daily (OR = 0.68 (0.45;0.86)) than those with the highest income. Lowest socio-economic groups, particularly women, spend more time preparing food than high socioeconomic

Gender disparity in late-life cognitive functioning in India: findings from the longitudinal aging study in India.

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Lee, Jinkook; Shih, Regina; Feeney, Kevin; Langa, Kenneth M

2014-07-01

To examine gender disparities in cognitive functioning in India and the extent to which education explains this disparity in later life. This study uses baseline interviews of a prospective cohort study of 1,451 community-residing adults 45 years of age or older in four geographically diverse states of India (Karnataka, Kerala, Punjab, Rajasthan). Data collected during home visits includes cognitive performance tests, and rich sociodemographic, health, and psychosocial variables. The cognitive performance tests include episodic memory, numeracy, and a modified version of the Mini-Mental State Examination. We find gender disparity in cognitive function in India, and this disparity is greater in the north than the south. We also find that gender disparities in educational attainment, health, and social and economic activity explain the female cognitive disadvantage in later life. We report significant gender disparities in cognitive functioning among older Indian adults, which differ from gender disparities in cognition encountered in developed countries. Our models controlling for education, health status, and social and economic activity explain the disparity in southern India but not the region-specific disparity in the northern India. North Indian women may face additional sources of stress associated with discrimination against women that contribute to persistent disadvantages in cognitive functioning at older ages. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Classification of EU Countries in the Context of Corporate Income Tax

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Alena Andrejovská

2016-01-01

Full Text Available Taxes are an integral part of human society, regardless of the economic, cultural and political disparities between the countries. Income taxes of legal entities represent significant part of the budget, what is the reason for their timeliness and public discussion. The aim of the paper is a classification of the EU countries into economic groups and an assessment of the grouping these EU member states based on common characteristics in the area of corporate income taxes. Common features are determined by the structure of selected macroeconomic indicators: public debt, government budget balance, the overall tax burden, economic performance, nominal and effective tax rate. The analysis compares a range of methodological approaches of hierarchical (Ward linkage and median linkage, and non‑hierarchical clustering (k-means clustering and fuzzy cluster analysis. The results of cluster analysis grouped the monitored countries into five clusters based on common characteristics as the corporate income tax rate, economics performance and the level of public debt. The result of the analysis shows that despite of ongoing there are still differences present, which are present in the ratios of countries’ development as well as in the economic policies of the particular countries.

[Influence of income, income inequalities and social capital on the health of persons aged 65 and over in Spain in 2007].

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Karlsdotter, Kristina; Martín Martín, José Jesús; López del Amo González, María del Puerto

2011-12-01

The aim of this study is to evaluate the influence of personal income [absolute income hypothesis (AIH)], income inequality and welfare [relative income hypothesis (RIH)], and social capital on the health of older people. Multi-level, cross-sectional logit models are calculated separately for women and men. The database employed was the Spanish Life Conditions Survey for 2007. The population consists of 6,259 persons aged over 65 years living in the 17 autonomous regions of Spain. The results confirm the AIH hypothesis: higher personal income is associated with better health. Education is also associated with better self-perceived health. The RIH hypothesis is partially confirmed due to the association between the Gini coefficient, regional per capita welfare and self-perceived health in older people, but only for women. Two different measures of social capital are used: the value of services of social capital and the percentage of people aged over 65 belonging to an association. Both factors are statistically associated with better self-perceived health in women. This study is the first to contrast the associations among income, income inequalities, social capital and the health of elders in Spain. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Regional inequalities in child malnutrition in Egypt, Jordan, and Yemen: a Blinder-Oaxaca decomposition analysis.

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Sharaf, Mesbah Fathy; Rashad, Ahmed Shoukry

2016-12-01

There is substantial evidence that on average, urban children have better health outcomes than rural children. This paper investigates the underlying factors that account for the regional disparities in child malnutrition in three Arab countries, namely; Egypt, Jordan, and Yemen. We use data on a nationally representative sample from the most recent rounds of the Demographic and Health Survey. A Blinder-Oaxaca decomposition analysis is conducted to decompose the rural-urban differences in child nutrition outcomes into two components; one that is explained by regional differences in the level of the determinants (covariate effects), and another component that is explained by differences in the effect of the determinants on the child nutritional status (coefficient effects). Results show that the under-five stunting rates are 20 % in Egypt, 46.5 % in Yemen, and 7.7 % in Jordan. The rural- urban gap in child malnutrition was minor in the case of Egypt (2.3 %) and Jordan (1.5 %), while the regional gap was significant in the case of Yemen (17.7 %). Results of the Blinder-Oaxaca decomposition show that the covariate effect is dominant in the case of Yemen while the coefficients effect dominates in the case of Jordan. Income inequality between urban and rural households explains most of the malnutrition gap. Results were robust to the different decomposition weighting schemes. By identifying the underlying factors behind the rural- urban health disparities, the findings of this paper help in designing effective intervention measures aimed at reducing regional inequalities and improving population health outcomes.

The persistent gap in health-care coverage between low- and high-income workers in Washington State: BRFSS, 2003-2007.

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Fan, Z Joyce; Anderson, Naomi J; Foley, Michael; Rauser, Eddy; Silverstein, Barbara A

2011-01-01

We examined the disparities in health-care coverage between low- and high-income workers in Washington State (WA) to provide support for possible policy decisions for uninsured workers. We examined data from the WA Behavioral Risk Factor Surveillance System 2003-2007 and compared workers aged 18-64 years of low income (annual household income income (annual household income ≥$35,000) on proportions and sources of health-care coverage. We conducted multivariable logistic regression analyses on factors that were associated with the uninsured. Of the 54,536 survey respondents who were working-age adults in WA, 13,922 (25.5%) were low-income workers. The proportions of uninsured were 38.2% for low-income workers and 6.3% for high-income workers. While employment-based health benefits remained a dominant source of health insurance coverage, they covered only 40.2% of low-income workers relative to 81.5% of high-income workers. Besides income, workers were more likely to be uninsured if they were younger; male; Hispanic; less educated; not married; current smokers; self-employed; or employed in agriculture/forestry/fisheries, construction, and retail. More low-income workers (28.7%) reported cost as an issue in paying for health services than did their high-income counterparts (6.7%). A persistent gap in health-care coverage exists between low- and high-income workers. The identified characteristics of these workers can be used to implement policies to expand health insurance coverage.

The electrification of Nova Scotia, 1884--1973: Technological modernization as a response to regional disparity

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King, Lionel Bradley

This dissertation investigates local attempts to use technology as a force for regional rehabilitation in the economically-depressed Maritime region of Canada. At the time of Confederation in 1867, the Maritime province of Nova Scotia was prosperous, progressive, and cultured. By the end of the 1910s, the province had entered a long period of economic and social decline. Recent historiography has shown that, far from passively accepting their fate, Nova Scotians and other Maritimers, actively resisted marginalization with political, cultural, or social action. The thesis expands upon that literature by exploring technology-based strategies of provincial rehabilitation using Thomas P. Hughes's systems perspective and David E. Nye's semiotic approach. In doing so, it applies methods from the social constructivist school of the history of technology to the larger concerns of Maritime Canadian historiography. In large part, the North American culture of technology determined the ways in which Nova Scotians applied technological solutions to provincial concerns. Technology has long been central to the Western idea of progress. As the "high technology" of the late nineteenth and early twentieth centuries, electricity reinforced that view: its ephemeral nature and silent efficiency led people to endow it with transformative, even mystical, powers. As a result, Nova Scotians, adopted a program of electrical modernization in the late 1910s as a remedy for regional disparity. The Nova Scotia government's first step was the creation of an Ontario-style hydroelectric commission designed to bring order to the province's fragmented and inefficient electrical network. Over the next few decades, the Nova Scotia Power Commission implemented rural electrification, home modernization, and regional system-building models that had already proven successful in Ontario and the United States. The system-building philosophies behind these programs were adapted to local conditions and

Trends in income inequality, pro-poor income growth and income mobility

OpenAIRE

Jenkins, Stephen P.; Van Kerm, Philippe

2003-01-01

We provide an analytical framework within which changes in income inequality over time are related to the pattern of income growth across the income range, and the reshuffling of individuals in the income pecking order. We use it to explain how it was possible both for ?the poor? to have fared badly relatively to ?the rich? in the USA during the 1980s (when income inequality grew substantially), and also for income growth to have been pro-poor. Income growth was also pro-poor in Western Germa...

Economic Stress and Cortisol Among Postpartum Low-Income Mexican American Women: Buffering Influence of Family Support.

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Jewell, Shannon L; Luecken, Linda J; Gress-Smith, Jenna; Crnic, Keith A; Gonzales, Nancy A

2015-01-01

Low-income Mexican American women experience significant health disparities during the postpartum period. Contextual stressors, such as economic stress, are theorized to affect health via dysregulated cortisol output. However, cultural protective factors including strong family support may buffer the impact of stress. In a sample of 322 low-income Mexican American women (mother age 18-42; 82% Spanish-speaking; modal family income $10,000-$15,000), we examined the interactive influence of economic stress and family support at 6 weeks postpartum on maternal cortisol output (AUCg) during a mildly challenging mother-infant interaction task at 12 weeks postpartum, controlling for 6-week maternal cortisol and depressive symptoms. The interaction significantly predicted cortisol output such that higher economic stress predicted higher cortisol only among women reporting low family support. These results suggest that family support is an important protective resource for postpartum Mexican American women experiencing elevated economic stress.

High-Amplitude Atlantic Hurricanes Produce Disparate Mortality in Small, Low-Income Countries.

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Dresser, Caleb; Allison, Jeroan; Broach, John; Smith, Mary-Elise; Milsten, Andrew

2016-12-01

Hurricanes cause substantial mortality, especially in developing nations, and climate science predicts that powerful hurricanes will increase in frequency during the coming decades. This study examined the association of wind speed and national economic conditions with mortality in a large sample of hurricane events in small countries. Economic, meteorological, and fatality data for 149 hurricane events in 16 nations between 1958 and 2011 were analyzed. Mortality rate was modeled with negative binomial regression implemented by generalized estimating equations to account for variable population exposure, sequence of storm events, exposure of multiple islands to the same storm, and nonlinear associations. Low-amplitude storms caused little mortality regardless of economic status. Among high-amplitude storms (Saffir-Simpson category 4 or 5), expected mortality rate was 0.72 deaths per 100,000 people (95% confidence interval [CI]: 0.16-1.28) for nations in the highest tertile of per capita gross domestic product (GDP) compared with 25.93 deaths per 100,000 people (95% CI: 13.30-38.55) for nations with low per capita GDP. Lower per capita GDP and higher wind speeds were associated with greater mortality rates in small countries. Excessive fatalities occurred when powerful storms struck resource-poor nations. Predictions of increasing storm amplitude over time suggest increasing disparity between death rates unless steps are taken to modify the risk profiles of poor nations. (Disaster Med Public Health Preparedness. 2016;10:832-837).

Regional variations in age at diagnosis and overall survival among patients with chronic myeloid leukemia from low and middle income countries.

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Mendizabal, Adam M; Garcia-Gonzalez, Pat; Levine, Paul H

2013-06-01

The epidemiology of chronic myeloid leukemia (CML) in low and middle income countries is limited. As a result, we analyzed a contemporary cohort of patients from low and middle income countries treated with Imatinib through The Glivec(®) International Patient Assistance Program (GIPAP). Generalized estimating equations (GEE) and Kaplan-Meier estimation were utilized to test for regional variations in age at diagnosis and overall survival among 33,985 patients from 94 countries. Patients participated from Asia (79.2%), Africa (9.4%), Latin America (8.7%) and Southern/Eastern Europe (2.5%). Sixty-one (61.2%) percent were male. Mean age at diagnosis was 38.5 years (9.4% 1 year; decreasing to 15.5% in 2010 (p 1-year (p 400 mg (p age at diagnosis and overall survival exist within and between regions. Additional epidemiological studies should be conducted to assess for possible environmental factors associated with the earlier age at onset. Copyright © 2013 Elsevier Ltd. All rights reserved.

National and state-specific health insurance disparities for adults in same-sex relationships.

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Gonzales, Gilbert; Blewett, Lynn A

2014-02-01

We examined national and state-specific disparities in health insurance coverage, specifically employer-sponsored insurance (ESI) coverage, for adults in same-sex relationships. We used data from the American Community Survey to identify adults (aged 25-64 years) in same-sex relationships (n = 31,947), married opposite-sex relationships (n = 3,060,711), and unmarried opposite-sex relationships (n = 259,147). We estimated multinomial logistic regression models and state-specific relative differences in ESI coverage with predictive margins. Men and women in same-sex relationships were less likely to have ESI than were their married counterparts in opposite-sex relationships. We found ESI disparities among adults in same-sex relationships in every region, but we found the largest ESI gaps for men in the South and for women in the Midwest. ESI disparities were narrower in states that had extended legal same-sex marriage, civil unions, and broad domestic partnerships. Men and women in same-sex relationships experience disparities in health insurance coverage across the country, but residing in a state that recognizes legal same-sex marriage, civil unions, or broad domestic partnerships may improve access to ESI for same-sex spouses and domestic partners.

Housing, income inequality and child injury mortality in Europe: a cross-sectional study.

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Sengoelge, M; Hasselberg, M; Ormandy, D; Laflamme, L

2014-03-01

Child poverty rates are compared throughout Europe to monitor how countries are caring for their children. Child poverty reduction measures need to consider the importance of safe living environments for all children. In this study we investigate how European country-level economic disparity and housing conditions relate to one another, and whether they differentially correlate with child injury mortality. We used an ecological, cross-sectional study design of 26 European countries of which 20 high-income and 6 upper-middle-income. Compositional characteristics of the home and its surroundings were extracted from the 2006 European Union Income Social Inclusion and Living Conditions Database (n = 203,000). Mortality data of children aged 1-14 years were derived from the World Health Organization Mortality Database. The main outcome measure was age standardized cause-specific injury mortality rates analysed by income inequality and housing and neighbourhood conditions. Nine measures of housing and neighbourhood conditions highly differentiating European households at country level were clustered into three dimensions, labelled respectively housing, neighbourhood and economic household strain. Income inequality significantly and positively correlated with housing strain (r = 0.62, P = 0.001) and household economic strain (r = 0.42, P = 0.009) but not significantly with neighbourhood strain (r = 0.34, P = 0.087). Child injury mortality rates correlated strongly with both country-level income inequality and housing strain, with very small age-specific differences. In the European context housing, neighbourhood and household economic strains worsened with increasing levels of income inequality. Child injury mortality rates are strongly and positively associated with both income inequality and housing strain, suggesting that housing material conditions could play a role in the association between income inequality and child health. © 2013 John Wiley & Sons Ltd.

Disparities in Infectious Disease Hospitalizations for American Indian/Alaska Native People

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Holman, Robert C.; Folkema, Arianne M.; Singleton, Rosalyn J.; Redd, John T.; Christensen, Krista Y.; Steiner, Claudia A.; Schonberger, Lawrence B.; Hennessy, Thomas W.; Cheek, James E.

2011-01-01

Objectives We described disparities in infectious disease (ID) hospitalizations for American Indian/Alaska Native (AI/AN) people. Methods We analyzed hospitalizations with an ID listed as the first discharge diagnosis in 1998–2006 for AI/AN people from the Indian Health Service National Patient Information Reporting System and compared them with records for the general U.S. population from the Nationwide Inpatient Survey. Results The ID hospitalization rate for AI/AN people declined during the study period. The 2004–2006 mean annual age-adjusted ID hospitalization rate for AI/AN people (1,708 per 100,000 populiation) was slightly higher than that for the U.S. population (1,610 per 100,000 population). The rate for AI/AN people was highest in the Southwest (2,314 per 100,000 population), Alaska (2,063 per 100,000 population), and Northern Plains West (1,957 per 100,000 population) regions, and among infants (9,315 per 100,000 population). ID hospitalizations accounted for approximately 22% of all AI/AN hospitalizations. Lower-respiratory--tract infections accounted for the largest proportion of ID hospitalizations among AI/AN people (35%) followed by skin and soft tissue infections (19%), and infections of the kidney, urinary tract, and bladder (11%). Conclusions Although the ID hospitalization rate for AI/AN people has declined, it remains higher than that for the U.S. general population, and is highest in the Southwest, Northern Plains West, and Alaska regions. Lower-respiratory-tract infections; skin and soft tissue infections; and kidney, urinary tract, and bladder infections contributed most to these health disparities. Future prevention strategies should focus on high-risk regions and age groups, along with illnesses contributing to health disparities. PMID:21800745

Income change alters default mode network connectivity for adolescents in poverty

Directory of Open Access Journals (Sweden)

David G. Weissman

2018-04-01

Full Text Available Experiencing poverty during childhood and adolescence may affect brain function. However, income is dynamic, and studies have not addressed whether income change relates to brain function. In the present study, we investigated whether intrinsic functional connectivity of default mode network (DMN regions was influenced by mean family income and family income change. Parents of 68 Mexican-origin adolescents (35 females reported family income annually when adolescents were 10–16 years old. Intercept and slope of income at each of these ages were calculated for each participant. At age 16 years, adolescents completed a resting state functional neuroimaging scan. Adolescents from high and low income families did not differ in their functional connectivity, but for adolescents in families with lower incomes, their connectivity patterns depended on their income slope. Low-income adolescents whose income increased demonstrated greater connectivity between the posterior cingulate cortex (PCC and the medial prefrontal cortex (mPFC, both DMN regions, and between the PCC and the right inferior frontal gyrus. Increases in income were associated with greater connectivity of the mPFC with the right inferior frontal gyrus and the left superior parietal lobule regardless of mean income. Increases in income, especially among adolescents in poverty, may alleviate stressors, influencing the development of brain networks. Keywords: Adversity, Brain, fMRI, Resting state, Socio-economic status, Youth

Income change alters default mode network connectivity for adolescents in poverty.

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Weissman, David G; Conger, Rand D; Robins, Richard W; Hastings, Paul D; Guyer, Amanda E

2018-04-01

Experiencing poverty during childhood and adolescence may affect brain function. However, income is dynamic, and studies have not addressed whether income change relates to brain function. In the present study, we investigated whether intrinsic functional connectivity of default mode network (DMN) regions was influenced by mean family income and family income change. Parents of 68 Mexican-origin adolescents (35 females) reported family income annually when adolescents were 10-16 years old. Intercept and slope of income at each of these ages were calculated for each participant. At age 16 years, adolescents completed a resting state functional neuroimaging scan. Adolescents from high and low income families did not differ in their functional connectivity, but for adolescents in families with lower incomes, their connectivity patterns depended on their income slope. Low-income adolescents whose income increased demonstrated greater connectivity between the posterior cingulate cortex (PCC) and the medial prefrontal cortex (mPFC), both DMN regions, and between the PCC and the right inferior frontal gyrus. Increases in income were associated with greater connectivity of the mPFC with the right inferior frontal gyrus and the left superior parietal lobule regardless of mean income. Increases in income, especially among adolescents in poverty, may alleviate stressors, influencing the development of brain networks. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Disseminating Health Disparities Education Through Tele-Learning

Directory of Open Access Journals (Sweden)

LaSonya Knowles

2008-08-01

Full Text Available Twenty years of research demonstrate that there are wide disparities in health throughout America. Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist when specific population subgroups are compared. Health Disparities in America: Working Toward Social Justice is a course instructed every fall by Dr. Lovell Jones, director of The Center for Research on Minority Health (CRMH at UT M.D. Anderson Cancer Center. The CRMH has created a course that examines the social and societal factors that are fundamental in creating disparities in health. Students from 10 different academic programs and institutions participate in this course. The course is unique in the aspect that various, diverse speakers whom are experts in their field of study instruct each class. This health disparities course is conducted at one of three different academic institutions in the Houston area and broadcast via satellite to various academic institutions by means of teleeducation. Tele-education is defined as a mode of instruction utilizing different forms of media such as video, audio technology tools and computers. Video and audio technologies involve the transmission of interface between learners and instructors, either interactive or non-interactive. Tele-education technologies have an important role to play in addressing the dissemination of health disparities education. The purpose of this program is to determine the feasibility of tele-education as a mode of instruction to introduce the multi-disciplinary components of health disparities. Our findings suggest that tele-education is a useful tool in imparting health disparities education.

Socioeconomic disparities in secondhand smoke exposure among US never-smoking adults: the National Health and Nutrition Examination Survey 1988-2010.

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Gan, Wen Qi; Mannino, David M; Jemal, Ahmedin

2015-11-01

Secondhand smoke (SHS) is a leading preventable cause of illness, disability and mortality. There is a lack of quantitative analyses on socioeconomic disparities in SHS; especially, it is not known how socioeconomic disparities have changed in the past two decades in the USA. To examine socioeconomic disparities and long-term temporal trends in SHS exposure among US never-smoking adults aged ≥20 years. 15 376 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2010 were included in the analysis of socioeconomic disparities; additional 8195 participants from NHANES III 1988-1994 were included in the temporal trend analysis. SHS exposure was assessed using self-reported exposure in the home and workplace as well as using serum cotinine concentrations ≥0.05 ng/mL. Individual socioeconomic status (SES) was assessed using poverty-to-income ratio. During the period 1999-2010, 6% and 14% of participants reported SHS exposure in the home and workplace, respectively; 40% had serum cotinine-indicated SHS exposure. Individual SES was strongly associated with SHS exposure in a dose-response fashion; participants in the lowest SES group were 2-3 times more likely to be exposed to SHS compared with those in the highest SES group. During the period 1988-2010, the prevalence declined over 60% for the three types of SHS exposure. However, for cotinine-indicated exposure, the magnitudes of the declines were smaller for lower SES groups compared with higher SES groups, leading to widening socioeconomic disparities in SHS exposure. SHS exposure is still widespread among US never-smoking adults, and socioeconomic disparities for cotinine-indicated exposure have substantially increased in the past two decades. 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/

Sleep and cognitive performance: the role of income and respiratory sinus arrhythmia reactivity.

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Staton, Lori; Hinnant, J Benjamin; Buckhalt, Joseph; El-Sheikh, Mona

2014-11-01

A health disparities view suggests that low family income status acts as a risk factor for poor cognitive functioning. A biosystems view suggests that poor sleep and poor stress response system functioning are also risk factors. These views are rarely integrated to test multiplicative risk or protective effects from social-cultural and biological variables. We investigated interactions among familial income, children's sleep and respiratory sinus arrhythmia reactivity (RSA reactivity, indexing parasympathetic nervous system reactivity) in the prediction of cognitive performance of school-aged children. Participants were 282 children (146 boys; 35% African American and 65% European American; M age = 9.42 years, SD = .71). Mothers reported on family income. Children's sleep quality (efficiency) and duration (minutes) were assessed via a week of actigraphy. Children's RSA reactivity to an attention demanding and frustrating star tracing challenge was assessed in the lab. Children completed standardized cognitive assessments examining attention, processing speed, and crystallized cognitive functioning. Findings show that more optimal sleep efficiency and RSA reactivity interact to confer protection against poor cognitive performance, particularly for children from lower income homes. Results build on the literature and suggest that interactions between biological systems and socioeconomic variables are key for understanding children's cognitive performance. © 2014 Wiley Periodicals, Inc.

Socio-demographic patterns of disability among older adult populations of low-income and middle-income countries: results from World Health Survey.

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Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kostanjsek, Nenad; Kowal, Paul; Officer, Alana; Chatterji, Somnath

2016-04-01

Our objective was to quantify disability prevalence among older adults of low- and middle-income countries, and measure socio-demographic distribution of disability. World Health Survey data included 53,447 adults aged 50 or older from 43 low- and middle-income countries. Disability was a binary classification, based on a composite score derived from self-reported functional difficulties. Socio-demographic variables included sex, age, marital status, area of residence, education level, and household economic status. A multivariate Poisson regression model with robust variance was used to assess associations between disability and socio-demographic variables. Overall, 33.3 % (95 % CI 32.2-34.4 %) of older adults reported disability. Disability was 1.5 times more common in females, and was positively associated with increasing age. Divorced/separated/widowed respondents reported higher disability rates in all but one study country, and education and wealth levels were inversely associated with disability rates. Urban residence tended to be advantageous over rural. Country-level datasets showed disparate patterns. Effective approaches aimed at disability prevention and improved disability management are warranted, including the inclusion of equity considerations in monitoring and evaluation activities.

Health disparities through a psychological lens.

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Adler, Nancy E

2009-11-01

There is growing concern in the United States about avoidable, unjust differences in health associated with sociodemographic characteristics, such as socioeconomic status and race/ethnicity. This concern has sparked research to identify how disparities develop and how they can be reduced. Studies showing that disparities occur at all levels of socioeconomic status, not simply at the very bottom, suggest that psychosocial factors play an important role. The author discusses both content and process issues in psychological research on disparities. Copyright 2009 by the American Psychological Association

Comprehensive taxonomy and worldwide trends in pharmaceutical policies in relation to country income status.

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Maniadakis, N; Kourlaba, G; Shen, J; Holtorf, A

2017-05-25

Rapidly evolving socioeconomic and technological trends make it challenging to improve access, effectiveness and efficiency in the use of pharmaceuticals. This paper identifies and systematically classifies the prevailing pharmaceutical policies worldwide in relation to a country's income status. A literature search was undertaken to identify and taxonomize prevailing policies worldwide. Countries that apply those policies and those that do not were then grouped by income status. Pharmaceutical policies are linked to a country's socioeconomics. Developed countries have universal coverage and control pharmaceuticals with external and internal price referencing systems, and indirect price-cost controls; they carry out health technology assessments and demand utilization controls. Price-volume and risk-sharing agreements are also evolving. Developing countries are underperforming in terms of coverage and they rely mostly on restrictive state controls to regulate prices and expenditure. There are significant disparities worldwide in the access to pharmaceuticals, their use, and the reimbursement of costs. The challenge in high-income countries is to maintain access to care whilst dealing with trends in technology and aging. Essential drugs should be available to all; however, many low- and middle-income countries still provide most of their population with only poor access to medicines. As economies grow, there should be greater investment in pharmaceutical care, looking to the policies of high-income countries to increase efficiency. Pharmaceutical companies could also develop special access schemes with low prices to facilitate coverage in low-income countries.

Does population have a larger impact on carbon dioxide emissions than income? Evidence from a cross-regional panel analysis in China

International Nuclear Information System (INIS)

Zhou, Yang; Liu, Yansui

2016-01-01

Highlights: • We reassessed the impact of demographic and GDP changes on CO 2 emissions in China. • Income rather than population growth was a major contributor to growing emissions. • Urbanisation increases energy use and CO 2 emissions, except in western China. • Shrinking household size did not reduce energy use and emissions. • The impact of human activities on the environment varies across regions. - Abstract: As global warming intensifies, the accumulation of carbon dioxide (CO 2 ) and other greenhouse gases have attracted great global attention. However, questions regarding whether, how and to what extent demographic factors and processes affect carbon emissions have not yet been fully explained – particularly in China. This study used an improved STIRPAT model to reassess the impact of demographic and income changes on China’s energy-related CO 2 emissions at the national and regional levels using balanced provincial panel data from the 1990–2012 period. Whereas most previous studies of emission–population/income elasticity in China have yielded wide-ranging estimates, this study showed that income rather than demographic change has been the dominant driving force behind China’s growing CO 2 emissions. Urbanisation has increased energy consumption and emissions, except in western China. Changes in the age structure have had a statistically insignificant effect on energy use, but resulted in increased national emissions – particularly in eastern China. Shrinking household size did not reduce energy use and emissions, indicating that improved residential energy efficiency might reduce emissions. Changing the traditional mode of economic growth, reasonable controlling the pace of urbanisation, improving energy efficiency and upgrading industrial structures may yet be necessary to mitigate the environmental impact of human activities in China.

Health-related disparities: influence of environmental factors.

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Olden, Kenneth; White, Sandra L

2005-07-01

populations, but their frequency can vary substantially,rendering individuals or groups more or less susceptible to particular environmental exposures. Such findings are consistent with the highly publicized analogy, "genetics loads the gun, but the environment pulls the trigger." That is, one can inherit the genetic predisposition to develop a disease but will do so only if or when exposed to the environmental trigger. Poor people have approximately the same genetic makeup as everyone else,but they have the unfortunate experience of living and working in environments containing multiple and high levels of carcinogens or other toxicants capable of interacting with susceptibility genes to cause disease.Furthermore, certain disadvantaged ethnic groups may have a higher incidence of certain susceptible genes that render them more vulnerable to adverse effects of the environments they inhabit. For both of these reasons,much of the nation's disease burden could likely be reduced through better environmental protection practices, especially in low-income and minority communities. Of the many implications of polymorphisms and frequency variations for public health and the practice of medicine, however, none is more urgent than the choice of drugs in therapy. Using such knowledge,randomized trials have identified race-specific drug response differences between blacks and whites [42].To date, most knowledge of the health effects of environmental factors is derived from studies of single agents. The reality, though, is that environmental contributions to health disparities are mostly from multiple agents. These simultaneous exposures to multiple risk factors, which may accumulate or interact synergistically, remain to be fully explained and defined.Finally, health disparity is a significant public health problem that cannot be solved using "business as usual" approaches for funding and priority setting. The current emphasis on basic and clinical research at the exclusion of public

Socio-economic disparities in the consumption of vegetables, fruit and energy-dense foods: the role of motive priorities.

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Konttinen, Hanna; Sarlio-Lähteenkorva, Sirpa; Silventoinen, Karri; Männistö, Satu; Haukkala, Ari

2013-05-01

A low socio-economic status (SES) is related to less healthy dietary habits, but the reasons for this remain unclear. We examined whether the absolute or relative importance of various food choice motives contributed to SES disparities in vegetable/fruit and energy-dense food intake. We analysed cross-sectional data from the FINRISK Study 2007 by means of structural equation modelling and used a shortened version of the Food Choice Questionnaire to assess the absolute importance of health, pleasure, convenience, price, familiarity and ethicality motives. We calculated the relative importance of each motive by dividing the participant's rating of it by his/her mean score on all motives. Dietary intake was measured with an FFQ. A population-based survey in Finland. Men (n 1691) and women (n 2059) aged 25-64 years. Higher education and income were related to a greater vegetable/fruit intake (β = 0·12, P foods (β = -0·09, P food choices in both absolute and relative terms. A higher income was related to a greater relative importance of health considerations. Relative motives were more strongly associated with vegetable/fruit and energy-dense food consumption than absolute motives and the relative importance of price, familiarity and health partly mediated the effects of the SES indicators on the consumption of these food items. Individual priorities in food choice motives, rather than the absolute importance of single motives, play a role in producing SES disparities in diet.

Socioeconomic inequalities of outpatient and inpatient service utilization in China: personal and regional perspectives.

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Zhu, Dawei; Guo, Na; Wang, Jian; Nicholas, Stephen; Chen, Li

2017-12-04

China's health system has shown remarkable progress in health provision and health outcomes in recent decades, however inequality in health care utilization persists and poses a serious social problem. While government pro-poor health policies addressed affordability as the major obstacle to equality in health care access, this policy direction deserves further examination. Our study examines the issue of health care inequalities in China, analyzing both regional and individual socioeconomic factors associated with the inequality, and provides evidence to improve governmental health policies. The China Health and Nutrition Survey (CHNS) 1991-2011 data were used to analyze the inequality of health care utilization. The random effects logistic regression technique was used to model health care utilization as the dependent variable, and income and regional location as the independent variables, controlling for individuals' age, gender, marital status, education, health insurance, body mass index (BMI), and period variations. The dynamic trend of 1991-2011 regional disparities was estimated using an interaction term between the regional group dummy and the wave dummy. The probability of using outpatient service and inpatient services during the previous 4 weeks was 8.6 and 1.1% respectively. Compared to urban residents, suburban (OR: 0.802, 95% CI: 0.720-0.893), town (OR: 0.722, 95% CI: 0.648-0.804), rich (OR: 0.728, 95% CI: 0.656-0.807) and poor village (OR: 0.778, 95% CI: 0.698-0.868) residents were less likely to use outpatient service; and rich (OR: 0.609, 95% CI: 0.472-0.785) and poor village (OR: 0.752, 95% CI: 0. 576-0.983) residents were less likely to use inpatient health care. But the differences between income groups were not significant, except the differences between top and bottom income group in outpatient service use. Regional location was a more important factor than individual characteristics in determining access to health care. Besides demand

Racial disparities in smoking knowledge among current smokers: data from the health information national trends surveys.

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Reimer, Rachel Ann; Gerrard, Meg; Gibbons, Frederick X

2010-10-01

Although African-Americans (Blacks) smoke fewer cigarettes per day than European-Americans (Whites), there is ample evidence that Blacks are more susceptible to smoking-related health consequences. A variety of behavioural, social and biological factors have been linked to this increased risk. There has been little research, however, on racial differences in smoking-related knowledge and perceived risk of lung cancer. The primary goal of the current study was to evaluate beliefs and knowledge that contribute to race disparities in lung cancer risk among current smokers. Data from two separate nationally representative surveys (the Health Information National Trends surveys 2003 and 2005) were analysed. Logistic and hierarchical regressions were conducted; gender, age, education level, annual household income and amount of smoking were included as covariates. In both studies, Black smokers were significantly more likely to endorse inaccurate statements than were White smokers, and did not estimate their lung cancer risk to be significantly higher than Whites. Results highlight an important racial disparity in public health knowledge among current smokers.

Neighborhood disparities in prevalence of childhood obesity among low-income children before and after implementation of New York City child care regulations.

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Sekhobo, Jackson P; Edmunds, Lynn S; Dalenius, Karen; Jernigan, Jan; Davis, Christopher F; Giddings, Mark; Lesesne, Catherine; Kettel Khan, Laura

2014-10-16

New York City Article 47 regulations, implemented in 2007, require licensed child care centers to improve the nutrition, physical activity, and television-viewing behaviors of enrolled children. To supplement an evaluation of the Article 47 regulations, we conducted an exploratory ecologic study to examine changes in childhood obesity prevalence among low-income preschool children enrolled in the Nutrition Program for Women, Infants, and Children (WIC) in New York City neighborhoods with or without a district public health office. We conducted the study 3 years before (from 2004 through 2006) and after (from 2008 through 2010) the implementation of the regulations in 2007. We used an ecologic, time-trend analysis to compare 3-year cumulative obesity prevalence among WIC-enrolled preschool children during 2004 to 2006 and 2008 to 2010. Outcome data were obtained from the New York State component of the Centers for Disease Control and Prevention's Pediatric Nutrition Surveillance System. Early childhood obesity prevalence declined in all study neighborhoods from 2004-2006 to 2008-2010. The greatest decline occurred in Manhattan high-risk neighborhoods where obesity prevalence decreased from 18.6% in 2004-2006 to 15.3% in 2008-2010. The results showed a narrowing of the gap in obesity prevalence between high-risk and low-risk neighborhoods in Manhattan and the Bronx, but not in Brooklyn. The reductions in early childhood obesity prevalence in some high-risk and low-risk neighborhoods in New York City suggest that progress was made in reducing health disparities during the years just before and after implementation of the 2007 regulations. Future research should consider the built environment and markers of differential exposure to known interventions and policies related to childhood obesity prevention.

Philanthropy and disparities: progress, challenges, and unfinished business.

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Mitchell, Faith; Sessions, Kathryn

2011-10-01

Philanthropy has invested millions of dollars to reduce disparities in health care and improve minority health. Grants to strengthen providers' cultural competence, diversify health professions, and collect data have improved understanding of and spurred action on disparities. The persistence of disparities in spite of these advances has shifted philanthropic attention toward strategies to change social, economic, and environmental conditions. We argue that these evolving perspectives, along with earlier groundwork, present new opportunities for funders, especially in combination with progress toward universal health coverage. This article looks at how philanthropy has addressed health disparities over the past decade, with a focus on accomplishments, the work remaining to be done, and how funders can help advance the disparities agenda.

Environmental Health Disparities in Housing

Science.gov (United States)

2011-01-01

The physical infrastructure and housing make human interaction possible and provide shelter. How well that infrastructure performs and which groups it serves have important implications for social equity and health. Populations in inadequate housing are more likely to have environmental diseases and injuries. Substantial disparities in housing have remained largely unchanged. Approximately 2.6 million (7.5%) non-Hispanic Blacks and 5.9 million Whites (2.8%) live in substandard housing. Segregation, lack of housing mobility, and homelessness are all associated with adverse health outcomes. Yet the experience with childhood lead poisoning in the United States has shown that housing-related disparities can be reduced. Effective interventions should be implemented to reduce environmental health disparities related to housing. PMID:21551378

Disparity in cancer care: a Canadian perspective

OpenAIRE

Ahmed, S.; Shahid, R.K.

2012-01-01

Canada is facing cancer crisis. Cancer has become the leading cause of death in Canada. Despite recent advances in cancer management and research, growing disparities in cancer care have been noticed, especially in socio-economically disadvantaged groups and under-served communities. With the rising incidence of cancer and the increasing numbers of minorities and of social disparities in general, and without appropriate interventions, cancer care disparities will become only more pronounced. ...

Disparities in the access to primary healthcare in rural areas from the county of Iasi - Romania.

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Duma, Olga-Odetta; Roşu, Solange Tamara; Manole, M; Petrariu, F D; Constantin, Brânduşa

2014-01-01

To identify the factors that may conduct to various forms of social exclusion of the population from the primary healthcare and to analyze health disparities as population-specific differences in the access to primary healthcare in rural compared to urban residence areas from Iasi, the second biggest county, situated in the North--East region of Romania. This research is a type of inquiry-based opinion survey of the access to primary healthcare in rural compared to urban areas of the county of Iasi. Data were collected by face-to-face interviews. There were taken into account the socioeconomic status (education level in the adult population, employment status, family income, household size) and two temporal variables (the interval of time spent to arrive at the primary healthcare office as a marker for the geographical access and the waiting time for a consultation). The study group consisted of two samples, from rural and urban area, each of 150 patients, all ages, randomly selected, who were waiting at the family doctor's practice. The study has identified disparities related to a poor economic status assessed through the employed status ("not working" 15% in urban and of 20% in rural).The income calculated per member of family and divided in terciles has recorded significant differences for "high" (36.7% urban and 14.7% rural) and "low", respectively (14.6% urban and 56.6% rural). High household size with more than five members represented 22.6% of the total subjects in rural and 15.3% in urban areas. The assessment of the education level in the adult population (> 18 years) revealed that in the rural areas more than a half (56%) of the sample is placed in the category primary and secondary incomplete, whereas the value for secondary complete and postsecondary was 37.3%. The proportion of respondents in the urban areas who have post-secondary education is five times higher than those in rural areas (15.4% vs. 2.7%). The reduced geographical access assessed as

Global stereo matching algorithm based on disparity range estimation