Inequality Comparisons Research Articles

Comparison of Wealth-Related Inequality in Tetanus Vaccination Coverage before and during Pregnancy: A Cross-Sectional Analysis of 72 Low- and Middle-Income Countries.

Immunization of pregnant women against tetanus is a key strategy for reducing tetanus morbidity and mortality while also achieving the goal of maternal and neonatal tetanus elimination. Despite substantial progress in improving newborn protection from tetanus at birth through maternal immunization, umbilical cord practices and sterilized and safe deliveries, inequitable gaps in protection remain. Notably, an infant's tetanus protection at birth is comprised of immunization received by the mother during and before the pregnancy (e.g., through childhood vaccination, booster doses, mass vaccination campaigns, or during prior pregnancies). In this work, we examine wealth-related inequalities in maternal tetanus toxoid containing vaccination coverage before pregnancy, during pregnancy, and at birth for 72 low- and middle-income countries with a recent Demographic and Health Survey or Multiple Indicator Cluster Survey (between 2013 and 2022). We summarize coverage levels and absolute and relative inequalities at each time point; compare the relative contributions of inequalities before and during pregnancy to inequalities at birth; and examine associations between inequalities and coverage levels. We present the findings for countries individually and on aggregate, by World Bank country income grouping, as well as by maternal and neonatal tetanus elimination status, finding that most of the inequality in tetanus immunization coverage at birth is introduced during pregnancy. Inequalities in coverage during pregnancy are most pronounced in low- and lower-middle-income countries, and even more so in countries which have not achieved maternal and neonatal tetanus elimination. These findings suggest that pregnancy is a key time of opportunity for equity-oriented interventions to improve maternal tetanus immunization coverage.

Enabling the examination of long-term mortality trends by educational level for England and Wales in a time-consistent and internationally comparable manner

BackgroundStudying long-term trends in educational inequalities in health is important for monitoring and policy evaluation. Data issues regarding the allocation of people to educational groups hamper the study and international comparison of educational inequalities in mortality. For the UK, this has been acknowledged, but no satisfactory solution has been proposed.ObjectiveTo enable the examination of long-term mortality trends by educational level for England and Wales (E&W) in a time-consistent and internationally comparable manner, we propose and implement an approach to deal with the data issues regarding mortality data by educational level.MethodsWe employed 10-year follow-ups of individuals aged 20+ from the Office for National Statistics Longitudinal Study (ONS-LS), which include education information from each decennial census (1971–2011) linked to individual death records, for a 1% representative sample of the E&W population. We assigned the individual cohort data to single ages and calendar years, and subsequently obtained aggregate all-cause mortality data by education, sex, age (30+), and year (1972–2017). Our data adjustment approach optimised the available education information at the individual level, and adjusts—at the aggregate level—for trend discontinuities related to the identified data issues, and for differences with country-level mortality data for the total population.ResultsThe approach resulted in (1) a time-consistent and internationally comparable categorisation of educational attainment into the low, middle, and high educated; (2) the adjustment of identified data-quality related discontinuities in the trends over time in the share of personyears and deaths by educational level, and in the crude and the age-standardised death rate by and across educational levels; (3) complete mortality data by education for ONS-LS members aged 30+ in 1972–2017 which aligns with country-level mortality data for the total population; and (4) the estimation of inequality measures using established methods. For those aged 30+ , both absolute and relative educational inequalities in mortality first increased and subsequently decreased.ConclusionWe obtained additional insights into long-term trends in educational inequalities in mortality in E&W, and illustrated the potential effects of different data issues. We recommend the use of (part of) the proposed approach in other contexts.

Comparison and Polyhedral Properties of Valid Inequalities for a Polytope of Schedules for Servicing Identical Requests

Comparison and Polyhedral Properties of Valid Inequalities for a Polytope of Schedules for Servicing Identical Requests

Socioeconomic inequalities in patient-reported outcome measures of Dutch primary hip and knee arthroplasty patients for osteoarthritis

To study socio-economic inequalities in patient-reported outcomes in primary hip and knee arthroplasty (THA/TKA) patients for osteoarthritis, using two analytical techniques. We obtained data from 44,732 THA and 30,756 TKA patients with preoperative and 12-month follow-up PROMs between 2014 and 2020 from the Dutch Arthroplasty Registry. A deprivation indicator based on neighborhood income, unemployment rate, and education level was linked and categorized into quintiles. The primary outcome measures were the EQ-5D-3L index and Oxford Hip/Knee Score (OHS/OKS) preoperative, at 12-month follow-up, and the calculated change score between these measurements. We contrasted the most and least deprived quintiles using multivariable linear regression, adjusting for patient characteristics. Concurrently, we calculated concentration indices as a non-arbitrary tool to quantify inequalities. Compared to the least deprived, the most deprived THA patients had poorer preoperative (EQ-5D -0.03 (95%CI -0.02, -0.04), OHS -1.26 (-0.99, -1.52)) and 12-month follow-up health (EQ-5D -0.02 (-0.01, -0.02), OHS -0.42 (-0.19, -0.65)), yet higher mean change (EQ-5D 0.02 (0.01, 0.03), OHS 0.84 (0.52, 1.16)). The most deprived TKA patients had similar results. The higher mean change among the deprived resulted from lower preoperative health in this group (confounding). After accounting for this, the most deprived patients had a lower mean change. The concentration indices showed similar inequality effects and provided information on the magnitude of inequalities over the entire socio-economic range. The most deprived THA and TKA patients have worse preoperative health, which persisted after surgery. The concentration indices allow comparison of inequalities across different outcomes (e.g., revision risk).

Comparison of inequality in utilization of postnatal care services between Bangladesh and Pakistan: Evidence from the Demographic and Health Survey 2017–2018

BackgroundInequality in postnatal care (PNC) has remained a challenge in many low- and middle-income countries, like Bangladesh and Pakistan. The study examines within-country and between-country inequality in utilizing PNC services for Bangladesh and Pakistan.MethodsThe study used the latest Demographic and Health Survey (DHS, 2017–2018) datasets of Bangladesh and Pakistan for women aged 15–49 years who had given at least one live birth in the three years preceding the survey. As outcome variables, three PNC service indicators were considered: PNC check of women, PNC check of newborns, and adequate PNC content of newborns. Concentration curves and equiplots were constructed to visually demonstrate inequality in PNC services. For ordered equity strata with more than two categories, the relative concentration index (RCI), absolute concentration index (ACI), and slope index of inequality (SII) were calculated to measure inequalities in the utilization of PNC services. For two categories equity strata, rate ratio (RR) and rate difference (RD) were calculated.ResultsIn Bangladesh, the level of inequality was high and almost the same for the PNC check of women and newborns based on women’s education (PNC women- RCI: 0.404, ACI: 0.403, SII: 0.624; and PNC newborn- RCI: 0.402, ACI: 0.402, SII: 0.622), wealth (PNC women- RCI: 0.448, ACI: 0.448, SII: 0.643; and PNC newborn- 0.441, ACI: 0.441, SII: 0.633), and number of ANC visits (PNC women- RCI: 0.329, ACI: 0.329, SII: 0.595; and PNC newborn- RCI: 0.329, ACI: 0.329, SII: 0.594). In Pakistan, the level of inequality was higher for the PNC check of women among all PNC services based on women’s education (ACI: 0.388 and SII: 0.676) and wealth (ACI: 0.397 and SII: 0.598). For Bangladesh and Pakistan, RR values (2.114 and 3.873, respectively) indicated greater media exposure-related inequality in adequate PNC content of newborns. Inequality in facility delivery was highest for PNC checks of women and newborns in Bangladesh (PNC women- RD: 0.905, PNC newborn- RD: 0.900) and Pakistan (PNC women- RD: 0.726, PNC newborn-RD: 0.743).ConclusionInequality was higher in Bangladesh than in Pakistan for PNC checks of women and newborns based on wealth, media exposure, and mode of delivery. For adequate PNC content of newborns, inequality was greater in Pakistan than in Bangladesh. Country-specific customized policies would better minimize the gap between the privileged and underprivileged groups and reduce inequality.

Cross-country comparison of income-related inequality in physical functional disability among middle-aged and older adults: Evidence from 33 countries

Physical functional disability is prevalent among middle-aged and older adults, with substantial health inequality. This study compared cross-country variation in the prevalence and inequality of physical functional disability and investigated the potential determinants of household income-related inequality.This cross-sectional study used data from 33 countries between 2017 and 2020, containing 141 016 participants aged 55 years and older. Physical functions were grouped into three domains: activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility function. Physical functional disability of each domain was indicated by having some difficulty with the activity. We first estimated the prevalence of physical functional disability in each country. Second, the concentration index was used to quantify household income-related health inequality. Finally, recentred influence function (RIF) decomposition method was used to decompose the inequality into individual and country-level determinants.Physical functional disability prevalence was higher in lower-middle-income countries than in high-income countries and more prevalent in the poor-income groups in all study countries. Besides, health inequality in different domains of disability was higher in high-income countries than in low-income countries. Regarding determinants of health inequality, we found that individual married, tertiary education, and country-level health infrastructure and resources were associated with reduced health inequality. In contrast, age, unhealthy lifestyles, and chronic diseases were associated with increased health inequality.Inequality in physical functional disability among middle-aged and older adults varies substantially across countries, with individual and macro determinants being contributing factors. Policies to achieve healthy ageing and reduce the inequality of physical function disability can focus on improving individual healthy lifestyles and country health care facilities.

Comparison of inequality in utilization of maternal healthcare services between Bangladesh and Pakistan: evidence from the demographic health survey 2017–2018

BackgroundInequality in maternal health has remained a challenge in many low-income countries, like Bangladesh and Pakistan. The study examines within-country and between-country inequality in utilization of maternal healthcare services for Bangladesh and Pakistan.MethodsThe study used the latest Demographic Health Surveys (DHS, 2017–2018) datasets of Bangladesh and Pakistan for women aged 15–49 years who had given at least one live birth in three years preceding the survey. Equity strata were identified from the literature and conformed by binary logistic regressions. For ordered equity strata with more than two categories, the relative concentration index (RCI), absolute concentration index (ACI) and the slope index of inequality (SII) were calculated to measure inequalities in the utilization of four maternal healthcare services. For two-categories equity strata, rate ratio (RR), and rate difference (RD) were calculated. Concentration curves and equiplots were constructed to visually demonstrate inequality in maternal healthcare services.ResultsIn Bangladesh, there was greater inequality in skilled birth attendance (SBA) based on wealth (RCI: 0.424, ACI: 0.423, and SII: 0.612), women’s education (RCI: 0.380, ACI: 0.379 and SII: 0.591), husband’s education (RCI: 0.375, ACI: 0.373 and SII: 0.554) and birth order (RCI: − 0.242, ACI: − 0.241, and SII: -0.393). According to RCI, ACI, and SII, there was inequality in Pakistan for at least four ANC visits by the skilled provider based on wealth (RCI: 0.516, ACI: 0.516 and SII: 0.738), women’s education (RCI: 0.470, ACI: 0.470 and SII: 0.757), and husband’s education (RCI: 0.380, ACI: 0.379 and SII: 0.572). For Bangladesh, the RR (1.422) and RD (0.201) imply more significant urban–rural inequality in SBA. In Pakistan, urban–rural inequality was greater for at least four ANC visits by the skilled provider (RR: 1.650 and RD 0.279).ConclusionInequality in maternal healthcare is greater among the underprivileged group in Pakistan than in Bangladesh. In Bangladesh, the SBA is the most inequitable maternal healthcare, while for Pakistan it is at least four ANC visits by the skilled provider. Customized policies based on country context would be more effective in bridging the gap between the privileged and underprivileged groups.

Comparison of health inequalities according to socioeconomic status: findings from the fourth Korean working condition survey: a cross-sectional study

this study aims to examine health inequalities among Korean workers by sex, age, education, monthly income, occupation, and employment type and identify groups of workers who may be neglected in the process of resolving health inequalities. we used data from the Fourth Korean Working Condition Survey conducted by the Korea Occupational Safety and Health Research Institute and compared the number of health symptoms among various groups using the t-test and one-way analysis of variance to determine their health status. We also calculated the Gini index of the number of health symptoms of each group and plotted the Lorenz curve to illustrate health inequalities. we found that the number of health symptoms was higher in groups with lower socioeconomic status (e.g., female, blue-collar workers, older, low education, low monthly income, and self-employed workers). However, the Gini index and Lorenz curve with respect to socioeconomic status indicated that health inequalities were higher among white-collar and permanent workers vis-à-vis blue-collar and self-employed workers, respectively. Further, it was found that health inequalities were higher among males than females with respect to the same occupational groups and employment types. general health policies are often targeted at the socially and economically vulnerable group, but according to the results of this study, it can be considered that there may be subjects who are vulnerable to health problems even in groups that are not socioeconomically vulnerable.

Health interventions and the unseen impact on equality

Health interventions and the unseen impact on equality

Comparative Constructions in the Language of the Holy Qur’an

The focus of the present paper is the expression of comparison in the language of the Qur’an, the language of the Divine Book of the Muslim nation. It investigates the two classes of inequality comparisons: comparative constructions and superlative constructions. It aims to provide a syntactic scrutinization of the two classes of comparison constructions and points out any similarities and distinctions that may be present between the two classes. The paper also sheds light on some recurrent rhetorical aspects of the construction as found in the instances of comparison constructions in the language of the Qur’an. The study shows that there are three types of each class, two of which are present in the two classes of comparison constructions. Deletion of an element(s), coordination of parameters or of construction(s) and comparison of items not sharing the same property of the comparison or of two distinct events are characterizing aspects of comparative constructions in the language of the Qur’an. To the best of my knowledge, the topic of comparison constructions in the language of the Qur’an has not been tackled before and hence the characterization provided in this paper is the original contribution of the current research.

Progressivity and Inequality

The concept of justice in taxation has been associated with the concepts underlying income inequality and its measurement. I take a fresh look at this connection in the light of recent UK experience and of results in the field of inequality measurement. This is developed in the context of several alternative empirical indicators of economic well-being and alternative approaches to characterising inequality comparisons. <strong>JEL codes:</strong> D31, D63

“Civilization” in History and Ideology Since 1800

Abstract The term “civilization,” articulated in eighteenth century Europe, has been widely used in many languages from the nineteenth century to the present. It refers both to widespread societies governed by powerful states in modern times and to prestigious urban and monumental civilizations of ancient times. This essay explores the history of the concept of civilization through science, ideology, and schooling. Scientific exploration of civilization was an implementation of emerging studies in social science. Ideological statement of social priorities appropriated civilization, especially in the era of expanding capitalism, empire, and white supremacy. In the school systems set up around the world, the term “civilization” was included in the curriculum both to explain ancient heritage and the comparison of modern great powers, religious faiths, and cultural practices. Weaknesses in the concept of civilization are becoming apparent as knowledge expands. New factors to consider include the significance of the end of empire; increased attention to network dynamics as well as hierarchies; comparisons of biological equality and social inequality; the roles of commoners and local scales; the rise of global social and institutional structures; shifting balances of societies and regions; and more attention to the historical role of schooling and science.

Sport Is Not Neutral: A Comparison of Gender Inequalities in Colombian and American Women’s Basketball Leagues

The negative consequences of patriarchy include gender inequality in sports. In both the United States and Colombia, the highest level of women’s basketball illustrates this problem. This research highlights two social and political dimensions of the problem. First, it exposes discrimination and the way in which the media trivialize the work performed by female basketball players; second, it questions the way in which women players are called “professionals” but are not always treated as such. Through a comparative analysis method, I explain some of the similar gender challenges faced by women’s basketball players in both the Women’s National Basketball Association (WNBA) in the United States and the Superior Women’s Basketball League (LSBF) in Colombia. In both countries, women basketball athletes have less media coverage than the men. The Colombian media, however, normalize the labor precariousness experienced by women basketball athletes. Frequently, the media call them “professionals,” but they are not treated as such. In America, female athletes have better labor conditions than Colombian women athletes. These conditions, however, are not equal to or better than those of male players in the (men’s) NBA.

Representative endowments and uniform Gini orderings of multi-attribute welfare

For the comparison of inequality and welfare in multiple attributes the use of generalized Gini indices is proposed. Individual endowment vectors are summarized by using attribute weights and aggregated in a spectral social evaluation function. Such functions are based on classes of spectral functions, ordered by their aversion to inequality. Given a spectrum and a set P of attribute weights, a multivariate Gini dominance ordering, being uniform in weights, is defined. If the endowment vectors are comonotonic, the dominance is determined by their marginal distributions; if not, the dependence structure of the endowment distribution has to be taken into account. For this, a set-valued representative endowment is introduced that characterizes the welfare of a d-dimensioned distribution. It consists of all points above the lower border of a convex compact in mathbb {R}^{d}, while the set ordering of representative endowments corresponds to uniform Gini dominance. An application is given to the welfare of 28 European countries. Properties of P-uniform Gini dominance are derived, including relations to other orderings of d-variate distributions such as convex and dependence orderings. The multi-dimensioned representative endowment can be efficiently calculated from data. In a sampling context, it consistently estimates its population version.

Consistent and inconsistent inequality indices for ordinal variables

Should inequality comparisons with ordinal variables be sensitive to alternative sorting of the categories? We introduce the consistency property whereby an inequality or bipolarisation index regards frequency distribution r less unequal than s if and only if it ranks the reverse-ordered distribution r ′ less unequal than s ′ for every pair of comparable frequency distributions. We characterise the class of consistent indices with a functional equation that serves as a useful test of the property. Applying the test to the most popular indices in the literature, we identify the respective consistent and inconsistent sets. • The consistency property for inequality comparisons with ordinal variables is introduced. • Consistent inequality comparisons are independent of the order of categorical sorting. • Consistent indices satisfy a functional equation that serves as a test of the property. • Inequality indices from the literature are classified into consistent or not with the test.

School vs. District Level Views of School Spending Inequality and Progressivity: Evidence from Florida and Illinois

ABSTRACT How much does spending vary across US public schools? And how much do the schools that low-income students attend spend compared to schools attended by their more advantaged peers? Students are educated in schools, which are frequently segregated by race and socioeconomic status, and spending can vary across schools within the same district. But this variation is invisible in revenue and expenditure data reported and analyzed at the district level, rather than school level, as has typically been done in the school finance literature to date (because of data limitations). Because the scope for within-district spending inequality is greater in larger districts that have many schools, differences in the number of schools per district may distort comparisons across states. To illustrate this phenomenon we analyze two states: Florida, which has 67 regular school districts, and Illinois, which enrolls fewer students in total, but has nearly 900 regular school districts. We construct measures of inequality and progressivity using school-level and district-level data. We show that across-school, within-district inequality is indeed higher in Florida than in Illinois. As expected, comparisons of inequality and progressivity based on district-level averages exaggerate the differences between the two states.

The Circlet Inequalities: A New, Circulant-Based, Facet-Defining Inequality for the TSP

Facet-defining inequalities of the symmetric traveling salesman problem (TSP) polytope play a prominent role in both polyhedral TSP research and state-of-the-art TSP solvers. In this paper, we introduce a new class of facet-defining inequalities, the circlet inequalities. These inequalities were first conjectured in Gutekunst and Williamson [Gutekunst SC, Williamson DP (2019) Characterizing the integrality gap of the subtour LP for the circulant traveling salesman problem. SIAM J. Discrete Math. 33(4):2452–2478] when studying the circulant TSP, and they provide a bridge between polyhedral TSP research and number-theoretic investigations of Hamiltonian cycles stemming from a conjecture from Marco Buratti in 2007. The circlet inequalities exhibit circulant symmetry by placing the same weight on all edges of a given length; our main proof exploits this symmetry to prove the validity of the circlet inequalities. We then show that the circlet inequalities are facet-defining and compute their strength following Goemans [Goemans MX (1995) Worst-case comparison of valid inequalities for the TSP. Math. Programming 69:335–349]; they achieve the same worst case strength as the similarly circulant crown inequalities of Naddef and Rinaldi [Naddef D, Rinaldi G (1992) The crown inequalities for the symmetric traveling salesman polytope. Math. Oper. Res. 17(2):308–326] but are generally stronger. Funding: This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program [Grant DGE-1650441] and by the National Science Foundation Division of Computing and Communications Foundations [Grant CCF-1908517].

Wealth inequality in interwar Poland

ABSTRACT In 1923 Poland introduced an extraordinary wealth tax. I have used internal statistics of the Ministry of the Treasury to estimate wealth inequality in interwar Poland. This data source was not previously used by researchers. There are no estimates of wealth inequality in interwar Poland available in the literature. According to my estimates, the top 0.01% of wealth owners controlled 14.8% of total private wealth. The wealth share of the top 1% stood at 37.5%. The top decile owned 60.7% of total private wealth. Wealth inequality varied strongly by region. A comparison of wealth inequality in Poland with wealth inequality in other European countries in the interwar period yields a diverse picture. The wealth share of the top 0.01% was the highest in Europe, the wealth share of the top 1% was in the middle of the European ranking, and the wealth share of the top 10% was almost the lowest in Europe. The small elite of super-rich (0.01%) controlled a higher share of national wealth than their European peers, but the wealth share of the rest of the top decile was relatively low. The unequal development of former partitions may partially explain the very high top wealth shares.

Cumulative advantages and disadvantages in attainment of higher education: Set-analytic comparison of asymmetric inequalities in six European countries

This article explores how parental resources work together to secure higher education for their offspring. It does so by, first, mapping the linkages between cumulative advantages and disadvantages of respondents’ parental resources and educational attainment across countries and cohorts. Second, investigating under which institutional setup of education systems these linkages between parental background and educational attainment are the weakest. At both levels, the set-analytic approach is applied. We show that disadvantages tend to cumulate to a much greater extent than advantages and their role in hindering higher educational attainment is much stronger than advantages to enable it. The only configuration of educational system that is sufficient to mitigate linkages between cumulative background and educational attainment in both directions, that is, advantageous background to enable and disadvantageous background to hinder higher educational attainment, combines high levels of standardization and decommodification.

The emergence of international comparisons of health inequalities as reflected in the Scandinavian Journal of Public Health during its five decades.

Aims:We examined the development of research articles published in the Scandinavian Journal of Public Health and its predecessors Acta Socio-Medica Scandinavica and the Scandinavian Journal of Social Medicine from 1969 until 2020 to be able to identify the place of international comparisons of socioeconomic inequalities in health in the journal.Methods:Altogether 3237 research articles were screened to yield 126 comparative research articles. Examining full texts of the comparative articles led to 13 articles reporting comparisons of health inequalities.Results:The first one came out in 1972, but the rest only after the mid-1990s. The most common socioeconomic indicator was education, but also occupational class and income was used. The most common health indicator was self-rated health. The articles compared Nordic countries with each other, but also with non-Nordic countries. Although the number of comparative studies on health inequalities was relatively small, there were examples of well-designed studies using advanced methodology. We examined only published journal articles over the past five decades, not submitted but rejected papers.Conclusions: In the Scandinavian Journal of Public Health and its predecessors, comparisons of health inequalities were few and emerged relatively late, that is, during the past two decades.