The impact of social inequalities on cancer incidence and mortality in a Brazilian City: Data from the population-based cancer registry.

One of the responsibilities of health systems is to protect citizens from the financial burdens caused by disease. This study aimed to estimate the economic burden of the coronavirus disease 2019 (COVID-19) on hospitalized patients and identifying its determinants. The current cross-sectional study was conducted during the sixth peak of COVID-19 in Iran (summer and fall 2021) with the participation of 400 hospitalized patients at Kowsar Hospital in Semnan from the patients' perspective. The data was collected using the patients' medical records and through interviewing with the patients. We used a researcher-made questionnaire, whose content validity was confirmed by scores of 0.91 and 0.93, respectively, for content validity ratio (CVR) and content validity index (CVI). Depending on the nature of the independent and dependent variables, student's t-test, analysis of variance (ANOVA), Chi-square, linear regression, and Tukey's post-hoc tests were used. The economic estimations revealed that hospitalized COVID-19 patients and their families paid 2773.43 USD (116484080 IRR) monthly, of which 1833.43 USD (77004080 IRR) (66%) was related to direct medical costs, 357.97 USD (15035000 IRR) (13%) to direct non-medical costs, and 582.02 USD (24445000 IRR) (21%) to indirect costs. In addition to the factors relating to the severity of the disease and its side effects, a wide range of demographic and contextual factors, including age, gender, residence status, residence region (urban or rural), type of basic and supplementary insurance, location of care, presence of an underlying disease, and receiving medication for the underlying disease had an impact on the total cost. According to our results, COVID-19 hospitalization had a significant financial impact on hospitalized patients and their families, just like complicated procedures or chronic severe illnesses. We also identified significant geographic, economic, and employment-related health inequities.

Despite significant resources invested in malaria control interventions for several years, the disease remains a persistent health challenge impacting millions of people especially children and pregnant women in the lower income regions of the world. Progress towards eliminating malaria has stagnated, in part due to the limited consideration of the social determinants of the disease such as poverty. We conducted a qualitative study exploring stakeholder perspectives on social determinants of malaria including lived experiences with the disease in Wakiso, one of the districts with high malaria cases in Uganda. This was a cross-sectional study using fourteen key informant interviews at community, health facility, district and national levels, 10 focus group discussions among community members and community health workers, and 11 in-depth interviews with household heads. Data collection was conducted in English and Luganda (local language), transcribed, coded using Atlas.ti. (version 6) and Nvivo (version 14) and analysed using a thematic approach. This paper focuses on the perspectives on poverty as a social determinant of malaria. The participants linked poverty to malaria through five themes: poor housing conditions; limited access to malaria control services; limited water and sanitation-related exposures; occupational and psychological exposures; and heavy economic burden (consequences) of malaria. The themes are presented under various sub-themes which separately highlight in detail the different pathways of the malaria-poverty relationship. These include: substandard housing structures enabling mosquito exposure; building close to mosquito breeding grounds; homelessness and street life; inadequate malaria prevention and treatment services; limited access to water supply; poor sanitation and waste management practices; occupational exposures; social and psychological constraints; high treatment costs; undernutrition causing low immunity; and loss of income. These perspectives emphasize a cyclic poverty-malaria relationship through the high treatment costs and loss of income due to illness or livelihood disruption. Malaria is rooted in economic inequalities suggesting that improvement in malaria control interventions through policies and frameworks that address poverty as a consequence, and driver of the disease should be prioritised. The study underscores the need for integrated malaria control strategies that address vulnerabilities related to poverty in all its dimensions-economic, environmental and psychosocial.

This study examines how university-educated NEET (Not in Education, Employment, or Training) youth in Türkiye perceive and experience economic inequality and its psychosocial consequences. Using Interpretative Phenomenological Analysis, data were collected from 17 graduates aged 18–24 who had remained NEET for at least one year. Findings show that inequality is experienced not only as material deprivation but also as moral injustice and identity disruption, leading to low self-esteem, isolation, anger, and burnout. Participants emphasized the need for structured transition programs, career guidance, and psychosocial support. The study highlights the importance of integrated policies addressing both economic and psychosocial dimensions.

With growing consensus on the scale of climate change and its direct impacts on societies and economies, the debate on how direct climate damages cascade through interconnected economic systems eventually leading to profound indirect effects remains open amid limited quantitative evidence. The localised nature of climate risk means that regional economies may face stark differences in how they are impacted by the direct and indirect physical risks. In Europe, the world's fastest warming continent, concentrated local damages spill over asymmetrically into tightly-interconnected regional markets, potentially leading to increased inter-regional inequalities despite the continent's prioritisation of economic unity through its regional cohesion policy. Solid regionalized economy-wide analysis could identify if physical climate risks serve as structural drivers of future regional inequality, offering timely insights for policy interventions to curb exacerbating socio-economic adversities. Here, using an empirical dynamic computable general equilibrium model disaggregated to NUTS2 European regions, we explore a range of regional economic projections from two particularly costly climate-driven hazards: river flooding and sea-level rise. Our methodology captures complex economic feedbacks across granular regions and sectors to estimate both direct and indirect economic repercussions of combined sea-level rise and river flood events by 2100. We find that these climate-induced hazards represent an economically divergent force for the European regions. In contrast to aggregated studies, the resulting regional economic projections reveal wide heterogeneity in combined (direct and indirect) physical risks, with the most affected regions experiencing devastating declines in GDP up to 51% by 2100. Our disaggregated projections capture the effects of two climate-induced hazards with distinct geographical hotspots - coastal and inland - which occur simultaneously though unfold at different rates, enabling a detailed assessment of regional economic inequalities. Low income regions experience by far the highest proportional losses, leading to increases in both between and within-country regional inequality.

To systematically examine associations between six inequality indicators from different life-course domains and the adult prevalence of six non-communicable diseases (NCDs) within a Nordic population-based study. We conducted a cross-sectional analysis using data from the seventh Tromsø Study survey (2015-2016) in Norway. All residents aged ⩾40 years were invited (65% participation). Age-adjusted, sex-stratified logistic regression models were used to assess associations between inequality indicators (parental and own educational level, childhood economic status, adverse childhood experiences (ACEs), income, and subjective occupational status) on continuous 0-1 cumulative proportion scales, and NCDs (major adverse cardiovascular events (MACE), cancer, chronic obstructive pulmonary disease (COPD), diabetes, musculoskeletal symptoms, and mental distress). Odds ratios (ORs), with 95% confidence intervals (CIs), were estimated, where OR >1 indicates higher odds of an NCD with greater disadvantage. Among 21,069 participants, greater social and economic disadvantage was associated with higher odds of MACE, COPD, diabetes, musculoskeletal symptoms, and mental distress. For musculoskeletal symptoms, significant associations were observed across all inequality indicators in both sexes. The steepest gradients were observed in mental distress for ACEs in women (OR 7.81, 95% CI 6.20-9.86) and men (10.09, 7.34-13.88). In contrast, greater disadvantage was associated with lower odds of cancer for some indicators; sensitivity analyses indicated these findings reflected cancer types with known positive socioeconomic gradients. Life-course social and economic disadvantage was consistently associated with higher prevalence of MACE, COPD, diabetes, musculoskeletal symptoms, and mental distress, with the pattern and magnitude varying across inequality indicators and NCDs.

The archaeological and historical record allows us to study the patterns of economic inequalities associated with sharply contrasting institutions such as communal property in societies without states, private property among small holders, and slavery, in economies relying on radically different technologies, based for example on human energy alone, other animal power, and carbon-based power. But the price of using prehistoric and historical data to expand the range of institutions and technologies under study is a substantial and typically unknown level of uncertainty and unrepresentativeness in the resulting estimates. We provide methods and code that quantify the degree of uncertainty, an approach that we term BRIDGE (Bayesian-Resampling and Informed Priors with Data-driven Gini Estimation). We transform raw wealth data from 431 sites and dates into probability distributions representing likely levels of inequality that (insofar as possible) are representative of the underlying population (e.g., rectifying biases arising from small or nonrandom samples and the frequent absence of data on those entirely without wealth) and are comparable across differing asset types (e.g., burial goods, dwelling area, storage area, land cultivated), ownership units (individual or household), and scale (from villages to nations). These distributions are based on the raw data along with independent information that allows us to infer biases and levels of uncertainty. We also account for the propagation of uncertainty through every stage of the data generation and estimation process. We find that widely used methods (e.g., relying solely on conventional bootstrapping) provide misleading and for the most part substantially underestimated measures of uncertainty.

This article connects cultural taste to capitalist mechanisms of redistribution through the concept of political economy of taste. Building on Bourdieusian scholarship on recognition struggles and drawing on Mike Savage and Nancy Fraser, it examines how public performances of taste reshape representations of working-class culture and how these representations are mobilised by both far-right and centre-left elites to advance policies that redistribute economic resources upwards. The article develops the concept through two case studies: far-right politics and touristification. Combining theoretical discussion of existing literature and new empirical analyses of Giorgia Meloni's taste performances and touristification in Naples (Italy), it shows how positive recognition of working-class culture, framed as 'authentic' by political elites, opens new possibilities for capitalist accumulation, thus widening economic inequalities. The article argues that Bourdieusian taste studies have overlooked these dynamics because of their focus on the stratification of tastes, rather than on how taste can transform mechanisms of exploitation and expropriation. The article thus proposes a different epistemic orientation: towards taste as a political weapon reshaping national political economies.

Widening social, economic, and health inequities intensify the need for equity strategies in health care if population health is to be improved. EQUIP Health Care, a program of research and knowledge mobilization aimed at supporting health care organizations to promote equity, has been developing and testing organizational-level interventions. This process evaluation of the implementation of EQUIP Emergency, a collaboration among staff and leaders at three diverse Emergency Departments, community and Indigenous leaders, and researchers, provides direction to organizations wishing to promote health and health care equity. This process evaluation, grounded in the Active Implementation Frameworks, is based on analysis of qualitative comments from a staff survey (n = 313 comments), qualitative interviews with staff, leaders, and researchers (n = 43), and observational data captured as fieldnotes (n = 784 entries). A thematic analysis identified four themes pertaining to the process and implications of engaging with EQUIP Emergency. Despite a rhetorical and practical commitment to equity at all levels, other priorities, including ensuring staffing adequate to provide care, orienting new staff, and responding to escalating crises such as the unregulated drug poisoning emergency, violence in Emergency Departments, and later in the study, COVID-19, overshadowed efforts toward equity. The material (e.g. staffing) and non-material (e.g. skills) resources available to support and aligned with equity goals shaped the capacity of staff, leaders, and the organizations to enact equity goals. Our analysis led to 10 suggestions for leaders at all levels of health care, including clinical, executive, and policy leaders, for systematically cultivating equity in health care service settings. To promote equity, health care organizations must approach equity as foundational, not as an "add-on," link equity to key organizational issues, engage leaders from all relevant employment groups at the outset and throughout, engage and compensate staff at all levels and from all roles, and counter siloed bureaucracies (systemic structural misalignments) within their systems. Time for leaders to comprehensively plan should be augmented with analysis of local patient and staff data that can be shared with direct care providers to set the stage for implementing equity strategies and evaluating progress as an embedded way of doing business. Clinical Trials.gov #NCT03369678 (registration date November 18, 2017).

ABSTRACT Background: Young people with intellectual disabilities experience persistent disadvantages in post-school outcomes. This study examined trends in post-school outcomes for young Australians with intellectual disabilities over a 10-year period, relative to peers with other disability types or no disabilities. Method: Using data from four waves of the Survey of Disability, Ageing and Carers (2012–2022), outcomes were examined for 20–29-year-olds with intellectual disabilities. Outcomes across five domains were examined: school completion, further education, labour force participation, income and government support. Results: Analyses showed a persistent pattern of inequality across all domains. While secondary school completion improved, these gains did not translate to further education or employment – gaps widened in both areas. Economic inequality, including low income and reliance on government support, remained unchanged. Conclusion: Despite major policy investment, outcomes remain poorer for this group. Greater focus on inclusion and coordinated cross-sector support is required to address entrenched inequities.

<sc></sc> This paper investigates the relationship between climate-related disasters and tax morale in 25 sub-Saharan African countries from 2011 to 2021. Using Afrobarometer survey data and disaster records from the International Disaster Database – Centre for Research on the Epidemiology of Disasters, we apply multilevel logistic regression and mediation analysis to assess direct and indirect relationships between five disaster types – droughts, extreme temperatures, floods, tropical storms, and wildfires – and tax morale. The results indicate heterogeneity across disaster types: floods are associated with higher tax morale, while droughts and extreme temperatures are associated with lower tax morale. The cumulative experience of multiple disasters is negatively associated with tax morale. Mediation analysis shows that disasters are associated with lower tax morale through increased economic inequality and eroded trust in public institutions, with these patterns more pronounced in rural areas and low-income countries. Further analysis shows that national disaster risk legislation in Benin, Kenya, and South Africa mitigates the negative relationship between disasters and tax morale. The findings highlight the importance of integrating climate resilience and equity considerations into tax policy, as well as strengthening public trust and addressing inequality, both necessary for sustaining tax compliance amid rising climate-related shocks.

Stunting in children in Kalimantan, Indonesia, a resource-rich region commonly seen as economically advantaged but with large social and economic inequities across provinces and districts, is examined in this secondary analysis. Many Kalimantan communities lack access to education, steady jobs, health services, and adequate nutrition, perpetuating childhood undernutrition despite the region's natural abundance and prosperity. We carefully examined 6038 children, using stature as the outcome and income as the exposure. Province, domicile, maternal age, marital status, education, occupation, children's age, gender, and early breastfeeding initiation were included as controls. Our binary logistic regression analysis matched earlier findings. The poorest people were 2.150 times more likely to be stunted (95% CI 2.096-2.205). A lower level increased the risk of stunting by 1.540 times (95% CI 1.504-1.577). The middle class was 1.397 times more likely to be stunted than the wealthy (95% CI 1.365-1.429). Richer people had 0.949 times the risk of stunting (95% CI 0.928-0.970). These findings show that economic growth and regional development in Kalimantan have not led to equitable nutritional outcomes for young children, highlighting the need for targeted, poverty-sensitive nutrition policies, improved social protection for underserved households, and context-specific interventions to address structural inequalities in early-life health.

Population trends in nutritional status and socioeconomic divergence in extreme obesity in Peru: geospatial dynamics and intergenerational risk.

The Health and Environmental Impacts, Safety, and Affordability of the EAT-Lancet Planetary Health Diet: A Multidisciplinary Systematic Review and Meta-Analysis.

2039 Background: Neuro-oncology is increasingly centralized in academic tertiary centers, potentially creating geographic and economic inequality. This study aims to quantify the national distribution of neuro-oncologists in the United States and evaluate the association between regional economic capacity, metropolitan urbanicity, and population-level clinical outcomes. Methods: We conducted a nationwide cross-sectional ecological analysis using 2025 United Council for Neurologic Subspecialties (UCNS) data, US Bureau of Economic Analysis state-level GDP, and US Census Bureau demographics. Spatial accessibility was modelled for US counties using geodesic distance from population centroids. Outcome measures included CNS tumor mortality and Disability-Adjusted Life Years (DALYs). Results: We identified 323 UCNS board-certified neuro-oncologists distributed across 70 Metropolitan Statistical Areas (MSAs). Workforce distribution was strongly associated with state-level economic magnitude (r=0.930 [95% CI: 0.878–0.960], p&lt;0.0001), with gross domestic product (GDP) explaining 86.4% of variance (R2=0.864). Critically, economic intensity independent of state population was a significant driver, with GDP per capita correlating with specialist density (r=0.344, p=0.014). Specialists were located exclusively within MSAs (𝜒² = 52.28, p &lt; 0.0001), however 81.9% of MSAs lacked local subspecialty presence. Spatial analysis revealed 45.4% of the US population has local access (&lt;20 miles), while 16.5% (55.2 million Americans) live in "Care Deserts" greater than 100 miles from the nearest neuro-oncologist. Increased specialist density predicted lower mortality rates for pediatric (ρ = –0.34 [95% CI: –0.56 to –0.07], p = 0.015) and adult (ρ = –0.352 [95% CI: –0.57 to –0.08], p = 0.011) groups. Similar inverse associations were observed for DALYs in both pediatric (ρ=−0.339 [95% CI: –0.57 to –0.07], p = 0.015) and adult (ρ=−0.347 [95% CI: –0.57 to –0.08], p = 0.013) populations. Conclusions: Distribution of UCNS board-certified neuro-oncologists in the United States is primarily governed by state-level economic prosperity and is critically concentrated in select metropolitan centers. This geographical concentration leaves over 80% of US metro areas without access to a UCNS board-certified neuro-oncologist. Furthermore, higher density of UCNS-certified specialists is significantly associated with reduced mortality and disease burden, suggesting that expanding this workforce may be a lever for improving population-level neuro-oncologic outcomes.

Artificial intelligence (AI) is transforming economic and political systems at a pace that outstrips existing governance capacities. While AI offers significant potential for innovation, its rapid and uneven diffusion is amplifying structural inequalities within and between states. This paper develops an integrated conceptual framework to explain how AI-driven technological disruption interacts with political economy dynamics to deepen inequality, erode fiscal capacity, and weaken the foundations of sustainable peace. It argues that AI reshapes labor markets, concentrates wealth and data governance power, and reinforces global asymmetries, producing a systemic pattern of vertical and horizontal inequality. These inequalities narrow domestic tax bases, heighten debt dependency, and redirect scarce fiscal resources away from peacebuilding priorities toward technological adaptation and crisis management. As a result, in fragile contexts, institutions face diminishing ability to provide essential services, address grievances, and maintain legitimacy. By linking AI-induced inequality with fiscal fragility, the paper frames technological transformation as a potential economic, political and security threat. The analysis advances policy pathways for mitigating these risks through inclusive AI governance, equitable global cooperation, progressive fiscal reforms, and investment in local technological capacity. Ensuring that AI becomes a driver of resilience rather than a catalyst for exclusion is essential for building durable and just peace in the digital age.

Individual entrepreneurial orientation from an economic lens: The U-shaped relationship with economic development and income inequality

Power is central to sociological accounts of economic inequality; however, buyer power-market conditions in which one or a few dominant employers can limit workers' outside options for employment-has received little attention relative to worker power. We study how the entry of Walmart Supercenters, the archetype of a high-buyer-power employer, affects the size and protective strength of union membership (a key dimension of worker power). We analyze (1) whether greater worker power dissuades Walmart Supercenters from entering a local labor market, (2) whether a successful Supercenter entry subsequently erodes local union membership, and (3) whether unions provide a protective effect against declining earnings after a successful Supercenter entry. We apply stacked difference-in-differences estimates based on county-year variation in Walmart Supercenter openings using restricted-access Panel Study of Income Dynamics data. We find that Walmart Supercenters are less likely to enter a local labor market that has high levels of union membership, even when conditioning on attempted Walmart entries. When Walmart Supercenter openings do occur, union membership declines by an average of 3.5 percentage points, and this is channeled through declining union membership in retail. Remaining union members are not protected against Walmart's downward pressure on earnings; in fact, annual earnings among workers who were unionized pre-treatment decline faster than for non-union members after a Walmart Supercenter opens. Worker power can be effective at preventing a rise in buyer power, but conditional on increases in buyer power, worker power tends to decline in terms of both size and protective strength. The sociological study of labor market power ought to consider how prevailing levels of buyer power can moderate the ability of organized labor to achieve its social and economic aims.

This research discusses in detail the concepts of nation and state and their relationship in creating global peace and lasting peace amidst the ever-evolving complexity of world life. A nation is understood as a group of people who share a common identity such as history, culture, language, and shared ideals, while a state is an organization authorized to regulate the lives of citizens within a territory through a sovereign government system. This research applies a qualitative method with a literature study approach derived from books, academic journals, and official documents, using descriptive-analytical and interpretive analysis to understand the relationship between these concepts. The results of the study reveal that the nation and state are complementary, where the nation serves as a socio-cultural foundation, while the state plays a political instrument to achieve collective goals. The evolution of the state from traditional to modern forms, especially in the context of the nation-state, reflects a transition towards a more democratic system based on the principle of popular sovereignty. On a global scale, international order serves as the primary basis for achieving peace, which not only means the absence of conflict, but also includes social justice, respect for human rights, and the equitable distribution of prosperity. However, various issues such as armed conflict, economic inequality, terrorism, and climate change demonstrate that achieving peace requires strong global cooperation and a shared commitment from every nation. Therefore, a deep understanding of the concepts of nation and state is crucial as a foundation for creating a more stable, just, and peaceful world order.

Game meat supply chains create variable safety risks and economic benefits across traders, yet research often focuses on hunters or consumers while overlooking meat preparation and processing roles. This study examines how zoonotic disease exposure, precautionary behaviors, and economic returns vary across hunters, vendors, and restaurant workers within the game meat trade in Cross River State, Nigeria. Between January 2023 and April 2024, we conducted 91 annual and 760 monthly interviews with 91 actors, including hunters, vendors, and restaurant workers, documenting handling practices, hygienic precautions, risk perceptions, and income derived from the game meat trade. Hunters reported the highest levels of direct contact with high-risk meat states and the lowest use of hygienic precautions. Vendors generated higher income than other actors, while hunters reported lower economic dependence on game meat than either vendors or restaurants. These findings demonstrate that game meat safety risks and livelihood benefits are distributed unevenly across value chains. Recognizing these asymmetries is essential for designing food safety interventions and policies that protect public health and anticipate differential impacts on livelihoods.