Changes In Social Inequalities Research Articles

Did social inequalities in child development change during the COVID-19 pandemic in Germany?

Abstract Background Early childhood development (aged <6 years) is dependent on the social conditions in which children live and strongly affect their life course trajectory. This study describes changes in social inequalities in language development during the COVID-19 pandemic based on data from the legally prescribed school entry examination in the German federal state of Brandenburg. The aim is to inform public health interventions for individuals at risk of long-term health inequalities. Methods Secondary data from three cohorts of 5-7-year-olds were used [n = 19,2992018|19; n = 19,9162019|20; n = 19,6982020|21]. Language development was assessed as delayed compared to peers [LD yes/no], measured by public health services using validated instruments. Descriptive bivariate and multivariate analyses [OR, 95%CI] examined language delay [%] with social inequalities defined by (1) an index composed of parents’ reported education and occupation [SEP low|high], (2) ‘German native language’ [yes|no] and (3) ‘years of kindergarten attendance’ [<4|≥4]. Results Overall, the proportion of LD decreased over the years (21.1%2018|19; 19.2%2019|20; 18.8%2020|21), both among children from families with high SEP (14.3%2018|19; 13.0%2020|21) and from German-speaking families (20.2%2018|19; 17.8%2020|21). LD rates among children increased with low SEP (42.4%2018|19; 43.4%2020|21) and remained constant with a non-German native language (36.0%2018|19; 35.5%2020|21). The probability for LD differed only for SEP (2018|19: ORlow|high=4.4, 3.93-4.94; 2020|21: ORlow|high=5.12, 4.54-5.77) and for native language (2018|19: ORnon-German|German=2.22, 1.86-2.66; 2020|21: ORnon-German|German=2.54, 2.19-2.95). Conclusions Social inequalities in language development based on SEP and native language increased slightly during the pandemic compared to the pre-pandemic period. Research should examine the effects of the pandemic on early development as well as protective and risk factors on a longitudinal basis. Key messages • Social inequality in early development increased in Germany during the COVID-19 pandemic. • To reduce health inequality in the life course, longitudinal research should assess the impact of the pandemic on child development.

Trends in social inequality in breastfeeding duration in Denmark 2002-2019.

The aim of the present study was to analyse trends in full breastfeeding for at least 4 months across socioeconomic position in Denmark over a 17-year-long period from 2002 to 2019 using parental education as the indicator of socioeconomic position. The study used data on full breastfeeding collected between 2002 and 2019 by community health nurses in the collaboration Child Health Database, n=143,075. Data were linked with five categories of parental education from population registers. Social inequality was calculated as both the relative (odds ratio) and absolute social inequality (slope index of inequality). A trend test was conducted to assess changes in social inequality over time. A social gradient in full breastfeeding was found for the entire study period. The odds ratio for not being fully breastfed for at least 4 months ranged from 3.30 (95% confidence interval 2.83-3.84) to 5.09 (95% confidence interval 4.28-6.06) during the study period for infants of parents with the lowest level of education (primary school) compared with infants of parents with the highest level of education (5+ years of university education). The slope index of inequality was between -38.86 and -48.81 during the entire study period, P=0.80. This indicated that both the relative and absolute social inequality in full breastfeeding to at least 4 months of age was unchanged in the study period from 2002 to 2019. This study showed a persistent relative and absolute social inequality in full breastfeeding for at least 4 months from 2002 to 2019 in Denmark.

Long waves, paradigm shifts, and income distribution, 1929–2010 and afterwards

The way income is distributed in an economy is perhaps the most notable result of its growth patterns. Understanding the joint persistence of economic crises and changes in social inequality since 1929 is considered a great challenge. This paper tries to analyze growth and income distribution in the long run using the concept of long waves, the evolutionary concept of ‘systems’, and empirical information. We conjecture that the social system is in turn an outcome of the co-evolution of four partially autonomous subdomains: (i) technology, characterized by a paradigm whose evolution follows the shape of a ‘Schumpeterian boom’; (ii) the economy or productive system, essentially defined as the succession of intermediate-length fluctuations in investments, and strongly associated to sectoral and structural changes; (iii) science, which contributes to development by generating innovations; and (iv) institutions, which set the rules in which income distribution is framed. Following this scheme, the data reveal that income distribution is an emerging result from this ‘global social system’ and not only the result of economic productivity and technology; apparently, the weight in the income distribution of institutional factors is as relevant as economic and technological factors. Second, the long-run growth trends are most possibly non-linear and, to great extent, non-deterministic, which would support the representation of long-run phenomena as long waves. Finally, we have found that in the long period 1929–2010 and afterwards, two sub-periods are manifested, with very different regimes of income distribution: (1) 1929–1975, when inequality decreased, and (2) from 1975 to present time, when inequality increased. Concerning the years after 2010, two alternatives follow: either these correspond to the recovery phase of a new long wave, or to the end of the depression phase of our second period. In both cases, we are currently moving towards the expansionary phase of a new long wave, which will have important implications for contemporary economic policies.

Editorial: Consequences of the Corona crisis for social inequalities in Germany

The possible consequences of the Corona crisis for social inequalities have received a lot of attention in public as well as scientific debates. On the one hand, concerns have been raised that the pandemic intensified pre-existing patterns of social inequality. On the other hand, the crisis has also been seen as an opportunity for social change and a renegotiation of social relationships. Complementing previous research that focused on the immediate consequences of the pandemic, this Special Issue is devoted to its longer-term effects. It unites six theory-guided empirical studies that use qualitative and quantitative longitudinal data to study changes in social inequality in the course of the pandemic in different life domains. Overall, the results do not show a universal trend of increased inequalities. While changes in different life domains occurred, such as better grading for students, intensified strong ties in families or increased social trust, there is only limited evidence of changes in social inequalities. In general, a complex picture of effects, consequences and concomitants of the pandemic appears.

ПАРАМЕТРИ ДОСЛІДЖЕННЯ СОЦІАЛЬНОЇ НЕРІВНОСТІ КРІЗЬ ПРИЗМУ РОЗРОБКИ ФІНАНСОВОЇ ПОЛІТИКИ ДЕРЖАВИ

The article discloses the parameters and indicators of measuring the state and changes in social inequality as a component and component of the formation of financial policy. The relevance of the analysis of the problems of the development of the financial policy of the state is determined by the large number of participants and the importance of taking into account the antagonistic interests of subjects interacting in the conditions of socially-oriented states, that is, those that prioritize the development of human capital, the creation of conditions for ensuring the rights and freedoms of citizens, the formation equal opportunities and leveling of negative manifestations of social inequality. It is proposed to consider social inequality as an indicator for evaluating the measures implemented in the field of financial relations and increasing the effectiveness of levers and tools for the implementation of the state's financial policy in terms of the development of a socially oriented economic system. The definition of the essence of "financial policy" is considered. The statement about the understanding of the essence of the financial policy of the state in terms of certain actions of the state regarding the management of financial resources in order to achieve the established goals and the performance of its functions by the state has been formed. The parameters of the measurement of social inequality and its interrelationship for the formation and implementation of the financial policy of the state are considered, namely from the point of view of the indicator of the effectiveness of the achievement of the established goals and the effectiveness of the levers of the financial policy. The importance of the study of social inequality in terms of the analysis of action not only in the sphere of social security is emphasized. It is proposed to study and analyze social inequality as an indicator of the effectiveness of financial policy implementation in the conditions of a socially-oriented economy, in two directions, namely: the level and quality of life of the population.

The positive and negative effects of the COVID-19 pandemic on subjective well-being and changes in social inequality: Evidence from prefectures in Japan

This study aims to specify the effects of the COVID-19 pandemic on individual subjective well-being in Japan and to clarify the mechanism generating social inequality of subjective well-being during the crisis. Data were analyzed using fixed effects ordinary least squares (OLS) regression models from the Online Panel Survey of Social Stratification and Psychology in 2020 (SSPW2020-Panel), which was conducted in four waves in June 2020, September 2020, December 2020, and March 2021. The results reveal that COVID-19 spread in a prefecture had differential effects on subjective well-being in prefectures with high infection rates: positive effects for socially advantaged individuals and negative effects for socially disadvantaged individuals. In conclusion, social inequality in Japan, in terms of subjective well-being, has been widened by the COVID-19 pandemic during 2020.

Changes in oral health inequalities in adults in Chile.

A secondary analysis of data from 2003 and 2016-2017National Health Surveys (NHS) in Chile was performed on seven oral health outcomes in adults: prevalence of untreated caries, prevalence of severe untreated caries, number of teeth with untreated caries, prevalence of functional dentition, prevalence of edentulism, number of remaining natural teeth and utilization of dental services. Inequalities were measured with the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) by education level. A decrease of caries inequalities measured with SII was observed from 2003 to 2016-17NHS but an increase of remaining teeth inequalities was measured. The SII of the remaining teeth increased from 6.6 [95% CI=5.0, 8.2] in 2003 to 8.8 [95% CI=7.3, 10.3] in 2016-17. The SII of functional dentition by education increased from 29.0 [95% CI=22.0, 36.0] in 2003 to 38.8 [95% CI=32.6, 45.0]) in 2016-17. The utilization of dental services ≤1year was the only outcome that showed a decrease in absolute and relative inequality, the SII was 33.9 [95% CI=23.3, 45.6] in 2003 and 26.2 [95% CI=16.6, 35.8] in 2016-17 and the RII decreased from 2.5 [95% CI=1.7, 3.3] in 2003 to RII=1.8 [95% CI=1.4, 2.3] in 2016-17. The increase of tooth loss inequalities in contrast to the decrease of inequalities in dental services utilization show the need to re-evaluate the current dental programmes for adults in Chile. This may include establishing a stronger oral health promotion strategy and greater dental treatment coverage focusing on avoiding tooth extractions in vulnerable social groups.

Secular trend and social variation in height of Polish schoolchildren between 1966 and 2012

To assess secular trend and changes in social inequalities of children's height across nearly 50years, when vast socio-political changes took place in Poland. Data on schoolchildren aged 7-18years were collected in 1966, 1978, 1988 and 2012 in Poland. Height was standardised for age using the LMS method. Socio-economic status (SES) was based on 4 factors: urbanisation level, mother's and father's education, and family size (number of children). Statistics included 2-way ANOVA with post hoc Tukey's test and effect size calculations. Positive secular trend in height was observed across all years. All analysed SES factors had significant effect on height which differed depending on SES category and year of Survey. Differences in height between extreme categories of SES factors decreased gradually, starting from 1978. However, only general SES in girls and urbanisation level in both sexes became insignificant in 2012. Improvement of living conditions across nearly 50years was reflected in the secular trend in children's height. Despite this improvement, however, the biological effects of social inequalities, visible in differences in height, to some extent, are still present in Poland.

Trend of social iniquities in reports of sexual violence in Brazil between 2010 and 2014.

Sexual violence has emerged in the health field with changes in the epidemiological profiles of populations. An ecological study with 5,565 Brazilian municipalities between 2010 and 2014. A descriptive analysis of the variables (Population rate of sexual violence reporting, household income per capita and HDI) and their stratification by quintile was performed. In order to explore the factors associated with changes in social inequalities regarding the rate of reporting of sexual violence, the Slope Index of Inequality and Relative Index of Inequality were adopted. An Equiplot was constructed for the outcome on each independent variable. The mean rate of reports of sexual violence in Brazil was 4.38 reports/100,000 inhabitants for the period. There was an increase in the rate of sexual violence and improvement in socioeconomic conditions. There was a higher rate of reporting in the quintile with better living conditions. An increase in the inequality of the rate of sexual violence as a function of household income and the HDI was observed. Several factors seem to influence the increase of reports of sexual violence in the country, among them the improvement in the living conditions of the population and greater moral sensitivity to violence. However, there is still a disparity in reporting among municipalities according to their socioeconomic status. The lack of public policies on social equity in health has interfered with reports of sexual violence in the country and has widened health inequities.

Socioeconomic position and body composition across the life course: a systematic review protocol

IntroductionThe relation between socioeconomic position (SEP) and obesity measured by body mass index (BMI) has been extensively reviewed, but there is less research on the association between SEP and body composition. Fat distribution and muscle quality have been linked to adverse health outcomes such as cardiovascular disease, diabetes and poor physical capability. There is some evidence of secular changes in body composition with increasing fat-mass and reducing muscle quantity and strength, but it is unclear whether there have been secular changes in social inequalities in body composition. The aim is to perform a systematic review of the existing literature on the association between SEP and body composition and to explore any secular changes.MethodsThe systematic review will be carried out according to PRISMA guidelines. An electronic search of MEDLINE and Embase Classic + Embase will be conducted using OvidSP as the database interface, as well as SPORTDiscus using EBSCO. Two independently working reviewers will initially screen abstracts to exclude papers that are clearly ineligible, followed by a full-text screening to exclude papers not meeting all inclusion criteria. Any disagreements will be resolved through discussion. Data extraction and quality assessment of eligible papers will be carried out by 2 reviewers using a standardised form. The reference lists of identified papers will be searched for additional papers. Original studies in the English language, which examine the association between SEP at any age and body composition at the same or later age will be included if they use any recognised measures of SEP (e.g. income, occupation, over-crowding) and a recognised measure of body composition (total, proportional or location of fat mass and fat-free mass, using any appropriate methods, excluding anthropometry). Due to expected heterogeneity, a narrative synthesis is expected, with a descriptive summary to be provided in tables. If there is consistency in reporting of associations, a random-effects meta-analysis will be used to provide an overall summary estimate.DiscussionThe results of the review will summarise the existing evidence on social inequalities in body composition. Findings will identify gaps in knowledge and where further research is required.Systematic review registrationPROSPERO CRD42019119937

Trends in Social Inequality in Exposure to Bullying at School 1994-2018

Aims: To examine social inequality in exposure to bullying at school among adolescents and changes in social inequality over time. We applied data from seven nationally representative school surveys in 1994, 1998, 2002, 2006, 2010, 2014 and 2018 in Denmark, the Health Behaviour in School-aged Children (HBSC) study.
 Methodology: The study population was 11-, 13- and 15-year-olds, response rate 87.9%, N=33,460 with comparable data about exposure to bullying and socioeconomic status. The analyses included 1) absolute social inequality, i.e. percent difference in exposure to bullying between low and high socioeconomic groups and 2) relative social inequality based on logistic regression analyses with odds ratios for exposure to bullying by socioeconomic background.
 Results: The prevalence of exposure to bullying decreased from 24.4% in 1994 to 4.9% in 2018. Bullying was significantly most prevalent among schoolchildren from lower socioeconomic groups. The absolute social inequality decreased from 10.7% in 1994 to 3.9% in 2018. The relative social inequality was 1.30 (1.19-1.43) in middle and 1.77 (1.59-1.96) in low socioeconomic group, compared to high. There was no significant change in relative social inequality from 1994 to 2018.
 Conclusion: In the period 1994 to 2018 with substantial reduction in exposure to bullying at school there was a decrease in the absolute social inequality and an unchanged relative social inequality in exposure to bullying.

Are There Changes in Inequalities in Injuries? A Review of Evidence in the WHO European Region.

Decreases in injury rates globally and in Europe in the past decades, although encouraging, may mask previously reported social inequalities between and within countries that persist or even increase. European research on this issue has not been systematically reviewed, which is the aim of this article. Between and within-country studies from the WHO European Region that investigate changes in social inequalities in injuries over time or in recent decades were sought in PubMed, Scopus, and Web of Science. Of the 27 studies retained, seven were cross-country and 20 were country-specific. Twelve reported changes in inequalities over time and the remaining 15 shed light on other aspects of inequalities. A substantial downward trend in injuries is reported for all causes and cause-specific ones—alongside persisting inequalities between countries and, in a majority of studies, within countries. Studies investigate diverse questions in different population groups. Depending on the social measure and injury outcome considered, many report inequalities in injuries albeit to a varying degree. Despite the downward trends in risk levels, relative social inequalities in injuries remain a persisting public health issue in the European Region.

Can the implementation of the Europe 2020 Strategy goals be efficient? The challenge for achieving social equality in the European Union

Research background: Economic crisis hit all the European Union Member States hard, with the impact of crisis varying considerably. The low growth performance in the EU has increased concerns regarding an increasing wage dispersion, income inequality at large, and social exclusion in line with poverty. Inequality should be seen as a cornerstone of both sustainable and inclusive growth under the Europe 2020 Strategy. Social inequality in the EU is a real problem, which hampers sustainable economic growth.
 Purpose of the article: The purpose of this study is to introduce evaluation of social development convergence and divergence trends between the EU Member States in the context of the Europe 2020 Strategy. The study gives an outline of the issues of the labour market and income disparities and poverty. Policymakers must be clear about what social objectives they are aiming to achieve, therefore special attention is paid to headline national goals of the Europe 2020 Strategy.
 Methods: The main task of this study is to assess social dimension and inequalities problems in the EU27 by applying Data Envelopment Analysis method, resp. time-series dynamic efficiency analysis in the form of output-oriented Malmquist Productivity Index. This study contains changes of key social equality indicators related to the Europe 2020 Strategy and compares objectives and general outlines of period 2010-2015, as well as the impact on national economics and living conditions.
 Findings & value added: Results contain elements of typology premises of the EU28 and point to a large diversity in inequality patterns, as the Author observes both increases and decreases in inequality at the EU level. Recent changes in social inequality have been associated with the business cycle, particularly with the accessibility of the labour market and, of course, with income inequality. Additionally, the development challenges are discussed for improvement of the socioeconomic well-being of the EU and to avoid social disparities.

Rising wealth, improving health? Adolescents and inequality

The linkage between social inequalities and health disparities is well established.1 Less well described are the connections between social inequalities during childhood and adolescence and adult health status.2 Additionally, little is known about changes in social inequalities during early life, and virtually nothing is known about how these changes might affect social gradients in non-communicable diseases (NCDs) later in life. In The Lancet, Frank Elgar and colleagues3 break new ground by examining secular trends in adolescents in socioeconomic inequalities and health disparities in factors contributing to NCDs.

Time trends in absolute and relative social inequality in smoking from 2007 to 2013 in the Capital Region of Denmark

Background Social inequality in smoking has been increasing in Western countries for decades due to the largest reduction in smoking prevalence being among socioeconomically advantaged groups. This study aimed to examine temporal changes in social inequality in daily smoking in the Capital Region of Denmark from 2007 to 2013 using both absolute and relative inequality measures. Methods Data from three health surveys in 2007, 2010 and 2013 in the Capital Region of Denmark was …

Changes in social inequalities in disability-free life expectancy in Southern Europe: the case of the Basque Country.

BackgroundHealth expectancy is a useful tool to monitor health inequalities. The evidence about the recent changes in social inequalities in healthy expectancy is relatively scarce and inconclusive, and most studies have focused on Anglo-Saxon and central or northern European countries. The objective of this study was to analyse the changes in socioeconomic inequalities in disability-free life expectancy in a Southern European population, the Basque Country, during the first decade of the 21st century.MethodsThis was an ecological cross-sectional study of temporal trends on the Basque population in 1999–2003 and 2004–2008. All-cause mortality rate, life expectancy, prevalence of disability and disability free-life expectancy were calculated for each period according to the deprivation level of the area of residence. The slope index of inequality and the relative index of inequality were calculated to summarize and compare the inequalities in the two periods.ResultsDisability free-life expectancy decreased as area deprivation increased both in men and in women. The difference between the most extreme groups in 2004–2008 was 6.7 years in men and 3.7 in women. Between 1999–2003 and 2004–2008, socioeconomic inequalities in life expectancy decreased, and inequalities in disability-free expectancy increased in men and decreased in women.ConclusionsThis study found important socioeconomic inequalities in health expectancy in the Basque Country. These inequalities increased in men and decreased in women in the first decade of the 21st century, during which the Basque Country saw considerable economic growth.

An explanatory analysis of economic and health inequality changes among Mexican indigenous people, 2000-2010.

IntroductionMexico faces important problems concerning income and health inequity. Mexico’s national public agenda prioritizes remedying current inequities between its indigenous and non-indigenous population groups. This study explores the changes in social inequalities among Mexico’s indigenous and non-indigenous populations for the time period 2000 to 2010 using routinely collected poverty, welfare and health indicator data.MethodsWe described changes in socioeconomic indicators (housing condition), poverty (Foster-Greer-Thorbecke and Sen-Shorrocks-Sen indexes), health indicators (childhood stunting and infant mortality) using diverse sources of nationally representative data.ResultsThis analysis provides consistent evidence of disparities in the Mexican indigenous population regarding both basic and crucial developmental indicators. Although developmental indicators have improved among the indigenous population, when we compare indigenous and non-indigenous people, the gap in socio-economic and developmental indicators persists.ConclusionsDespite a decade of efforts to promote public programs, poverty persists and is a particular burden for indigenous populations within Mexican society. In light of the results, it would be advisable to review public policy and to specifically target future policy to the needs of the indigenous population.

Using multiple measures to assess changes in social inequalities for breast cancer screening

To identify changes in social inequalities for mammograms uptake in Belgium over the period 1997-2008 using multiple indices, and to assess the contribution of the national breast cancer screening programme in these changes. Data were obtained from four waves of the Belgian Health Interview Survey. The socio-economic position was defined by the educational level. Inequalities were measured both with pairwise measures comparing extreme educational groups (prevalence difference and prevalence ratio), and with indices measuring the total inequality impact at population level: the Population Attributable Fraction (PAF), the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). All indices show a substantial decrease in inequalities in mammographic uptake between 1997 and 2008. For the indices of total impact (PAF, RII, SII), the change occurred between the first two waves (1997 and 2001) and stabilized afterwards, while for pairwise indices the evolution continued over the whole period. Using multiple indices of inequality is necessary for a more complete understanding of the changes: total impact inequality indices should always complement simple pairwise measures. The inequalities in mammograms uptake, as measured with total impact indices, only decreased before the start of the national screening programme.

An observational study to assess changes in social inequality in smoking-attributable upper aero digestive tract cancer mortality among Canadian males between 1986 and 2001

BackgroundTobacco and low socioeconomic status have been acknowledged as potential risk factors for upper aero-digestive tract (UADT) cancers in North America. In context of reducing adult male smoking prevalence (by over 50%), in the past few decades in Canada, this study tried to document changes in smoking-attributable UADT cancer mortality rates, among Canadian males of different social strata, between 1986 and 2001.MethodsThe contribution of smoking to UADT cancer mortality was estimated indirectly by using lung cancer mortality as an indicator of the accumulated mortality from smoking in a population. This method was applied to UADT cancer death rates of 35–69 year old socially stratified males. Data, stratified by neighborhood income quintile, could be obtained from Statistics Canada, for four census years, 1986, 1991, 1996, and 2001.ResultsA total of 2704 male deaths were analyzed. Between 1986 and 2001, UADT cancer deaths reduced by 30% (32 to 22 per 100,000) but the proportion of these deaths attributable to smoking reduced much more, by 41% (22 to 13 per 100,000). In the span of fifteen years, absolute social inequality (measured by rate difference between the highest and the lowest stratum) in smoking-attributable male UADT cancer mortality in Canada reduced by 47% and relative social inequality (measured by rate ratios) reduced by 9%.ConclusionThe present analyses reveal that between 1986 and 2001, smoking-attributable UADT cancer mortality rates among adult males (35–69 years) in Canada reduced in all social strata and the social inequalities in these rates have narrowed. Analysis of more current data will be of interest to confirm these trends.

Widening inequalities in the risk factors for cardiovascular disease amongst men in England between 1998 and 2006

Cardiovascular disease is a major cause of morbidity and mortality for which there are many modifiable risk factors. This study investigated changes in social inequalities of cardiovascular disease risk factors amongst men aged 20-64 years in England between 1998 and 2006. Repeated cross-sectional study. Health Survey for England data from 1998, 2003 and 2006 were used. The following physiological risk factors were considered: body mass index, waist-to-hip ratio, blood pressure and total serum cholesterol level. The behavioural risk factors considered were limited physical exercise, smoking status and level of social support. The National Statistics Socio-economic Classification was used to measure socio-economic position. An index of inequality for each risk factor was calculated, and change in inequality over time was assessed by t-tests. Significant cross-sectional inequality was found for waist-to-hip ratio, systolic blood pressure, smoking, limited physical exercise and social support at one or more time points. Between 1998 and 2006, there was a significant increase in inequality for smoking status [relative index of inequality (RII) 4.06-6.65 (t-test: 2.88, P=0.003)] and limited physical exercise [RII 1.06-1.74 (t-test: 2.92, P=0.003)]; these increases in inequality over time were due to improvements for those in higher socio-economic classes. Policies have not had the desired impact of reducing inequalities. Although the long-term effects of these policies might not yet be apparent, available evidence needs to be used to monitor impact and direct policy change to address the possibility of widening inequalities.