Greater Income Inequality Research Articles

Neighborhood income inequality associated with functional independence after ischemic stroke: a cohort study

BackgroundIndividual measures of socioeconomic status have been associated with post-stroke disability in patients with ischemic stroke. However, it is not known whether the distribution of income in a community may have an impact on stroke recovery. We hypothesized that increased neighborhood income inequality (as measured by the Gini index) may be associated with a slower recovery after stroke. MethodsThis was a retrospective cohort study of adult patients hospitalized at a comprehensive stroke center with acute ischemic stroke between 1/1/2018-12/31/2019. Individual patient data was abstracted from the EHR, and zip code Gini index was obtained from the US Census Bureau. Binary logistic regression was used to assess the relationship between Gini index and functional independence (modified Rankin scale ≤2) at discharge and first outpatient follow-up. These models controlled for patient demographics, stroke risk factors, stroke severity, and stroke treatment. A second binary regression was also performed using a subset of patients to assess possible predictors of being discharged as recommended (i.e. having a discharge destination that was consistent with the recommendation of the inpatient medical team). ResultsThree hundred and thirty-seven patients were included in this analysis. The median time to first outpatient follow-up was 35 days. Zip code Gini index was not associated with functional independence at discharge but was associated with independence at follow-up (modified Rankin scale ≤2) such that patients from higher inequality neighborhoods had decreased odds of being independent. More specifically, each 1% increase in neighborhood Gini index was associated with 8% decreased odds of independence at follow-up (OR=0.923, 95% CI: 0.863-0.987). Being discharged as recommended was associated with increased odds of independence at follow-up (OR=3.359, 95% CI: 1.055-10.695). Greater income inequality (OR=0.909, 95% CI: 0.841-0.983) and Asian race (OR=0.093, 95% CI: 0.011-0.766) were associated with decreased odds of being discharged as recommended. ConclusionAmong a cohort of patients with ischemic stroke, increased neighborhood income inequality was associated with decreased odds of achieving functional independence up (modified Rankin scale ≤2) by the time of first outpatient follow-up (at a median of 35 days following discharge). This disparity may be driven by discharge destination and race.

Is corporate community involvement associated with poverty and income inequality? International evidence

ABSTRACT This study explores the relationship between economic conditions and corporate community involvement (CCI) across an international dataset of 7,926 firm-year observations from 33 countries during 2013–2019. We investigate whether and how poverty levels and income inequality within a country are associated with firms’ engagement in social welfare initiatives. Our findings suggest that firms are more active in community contributions in the presence of severe poverty and greater income inequality. Specifically, in developed countries, both factors are strongly linked to CCI, while in developing countries, CCI primarily correlates with income inequality. This research contributes to the literature by showing that firms adjust their ESG strategies based on country-specific economic conditions.

Digital town square? Nextdoor's offline contexts and online discourse

There is scant quantitative research describing Nextdoor, the world's largest and most important hyperlocal social media network. Due to its localized structure, Nextdoor data are notoriously difficult to collect and work with. We build multiple datasets that allow us to generate descriptive analyses of the platform's offline contexts and online content. We first create a comprehensive dataset of all Nextdoor neighborhoods joined with U.S. Census data, which we analyze at the community-level (block-group). Our findings suggests that Nextdoor is primarily used in communities where the populations are whiter, more educated, more likely to own a home, and with higher levels of average income, potentially impacting the platform's ability to create new opportunities for social capital formation and citizen engagement. At the same time, Nextdoor neighborhoods are more likely to have active government agency accounts---and law enforcement agencies in particular---where offline communities are more urban, have larger nonwhite populations, greater income inequality, and higher average home values. We then build a convenience sample of 30 Nextdoor neighborhoods, for which we collect daily posts and comments appearing in the feed (115,716 posts and 163,903 comments), as well as associated metadata. Among the accounts for which we collected posts and comments, posts seeking or offering services were the most frequent, while those reporting potentially suspicious people or activities received the highest average number of comments. Taken together, our study describes the ecosystem of and discussion on Nextdoor, as well as introduces data for quantitatively studying the platform.

Exploring the association between income inequality and sleep in Canadian adolescents: A path analysis approach

ObjectivesAn estimated 30% of Canadian adolescents do not get the recommended 8-10hours of sleep. No prior study has examined the role of income inequality, the gap between rich and poor within a society, in adolescent sleep. The aim of this study is to examine the association between income inequality and sleep duration among Canadian adolescents, how this association differs by gender, and whether depressive symptoms, anxiety, and social cohesion mediate this relationship. MethodsMultilevel path models were conducted using cross-sectional survey data from 74,501 adolescents who participated in the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behavior (COMPASS) study in 2018-2019. Income inequality was measured at the census division level and sleep duration, gender, depressive symptoms, anxiety, and social cohesion were measured at the individual level. ResultsA 1% increase in income inequality was associated with a 3.67-minute decrease in sleep duration (95% CI=−5.64 to −1.70). The cross-level interactions between income inequality and gender were significant, suggesting that income inequality has more adverse associations with sleep among females than males. Both depressive symptoms and anxiety were significant mediators, wherein greater income inequality was associated with higher levels of depressive symptoms and anxiety, which were in turn, associated with a shorter sleep duration. ConclusionInterventions that reduce income inequality may prevent depressive symptoms and anxiety and improve sleep in adolescents. Reducing societal income gaps may improve adolescent sleep especially in those attending school in high income inequality areas, females, and those experiencing depressive symptoms and anxiety.

In Case You Haven't Heard…

Middle‐aged adults in the U.S. tend to report significantly higher levels of loneliness than their European counterparts, possibly due in part to weaker family ties and greater income inequality, according to research published in the journal American Psychologist, an American Psychological Association news release stated. “Our research illustrates that people feel lonelier in some countries than in others during middle age,” said lead author Frank Infurna, Ph.D., an associate professor of psychology at Arizona State University. “It also sheds light on reasons this may be occurring and how governments can address it with better policies.” Considering the increased public health focus in the United States, as evidenced by the U.S. Surgeon General's 2023 advisory on the epidemic of loneliness and isolation, and abroad, as countries such as the United Kingdom and Japan have appointed ministers to address the problem, the researchers explored how loneliness has historically changed over time and how it differs across countries. Infurna and his colleagues examined data from ongoing, nationally representative longitudinal surveys from the United States and 13 European countries, with more than 53,000 participants from three different generations: (the ‘Silent Generation,’ ‘Baby Boomers’ and ‘Generation X.’ Data were collected from 2002 to 2020 and only included responses given when participants were between the ages of 45 and 65.

Higher-risk SIPAT score predicts increased risk of long-term mortality in orthotopic heart transplant recipients

BackgroundOrthotopic heart transplantation (OHT) improves survival in eligible patients. Organ scarcity necessitates extensive clinical and psychosocial evaluations before listing. The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) predicts risk for poor psychosocial outcomes and morbidity in the first year post-transplant, yet it is unknown whether it predicts long-term outcomes. MethodsBlinded examiners obtained data from a retrospective cohort of 51 OHT recipients from a high-volume center. Patients with “Excellent” or “Good” SIPAT score indicating low psychosocial risk for transplant (E/G) were compared with those who met “Minimum Acceptable Criteria” or were “High Risk” (MAC/HR). Associations were examined between SIPAT group and outcomes. ResultsMAC/HR versus E/G recipients had significantly reduced survival in the 10 years post-OHT (mean 6.7 vs 8.8 years, p = 0.027; 55% vs 82% survival proportions, p = 0.037). MAC/HR patients were more likely to live in a county with greater income inequality (p = 0.025) and have psychiatric history pre-OHT (p = 0.046). Both groups had otherwise similar demographics and medical history. A lower proportion of MAC/HR patients adhered to medications post-OHT and a greater proportion had psychiatric illness, though differences were not significant. ConclusionsHigher-risk SIPAT scores predict reduced long-term survival post-OHT. Further efforts are crucial to improve outcomes in higher-risk patients.

Association Between Area-Level Income Inequality and Health-Related School Absenteeism: Evidence From the COMPASS Study.

Income inequality is theorized to impact health. However, evidence among adolescents is limited. This study examined the association between income inequality and health-related school absenteeism (HRSA) in adolescents. Participants were adolescents (n = 74,501) attending secondary schools (n = 136) that participated in the 2018-2019 wave of the COMPASS study. Chronic (missing ≥3 days of school in the previous 4 weeks) and problematic (missing ≥11 days of school in the previous 4 weeks) HRSA was self-reported. Income inequality was assessed via the Gini coefficient at the census division (CD) level. Multilevel modeling was used. Greater income inequality was associated with a higher likelihood of chronic and problematic HRSA (chronic: OR = 1.17, 95% CI: 1.06, 1.30; problematic: OR = 1.29, 95% CI 1.11 to 1.50). Increased predicted probabilities for Problematic HRSA were observed at greater degrees of income inequality among students who identified as either white, black, Latinx, or mixed, while protective associations were observed among students who identified as Asian or other. No associations were modified by gender. Income inequality demonstrated unfavorable associations with HRSA, which was modified by racial identity.

Implementation of carbon pricing in an aging world calls for targeted protection schemes.

Understanding the impact of climate fiscal policies on vulnerable groups is a prerequisite for equitable climate mitigation. However, there has been a lack of attention to the impacts of such policies on the elderly, especially the low-income elderly, in existing climate policy literature. Here, we quantify and compare the distributional impacts of carbon pricing on different age-income groups in the United States, the United Kingdom, and Japan and then on different age groups in other 28 developed countries. We find that the elderly are more vulnerable to carbon pricing than younger groups in the same income group. In particular, the low-income elderly and elderly in less wealthy countries face greater challenges because carbon pricing lead to both higher rate of increase in living cost among low-income elderly and greater income inequality within the same age group. In addition, the low-income elderly would benefit less than the younger groups within the same income group in the commonly proposed carbon revenues recycling schemes. The high vulnerability of the low-income elderly to carbon pricing calls for targeted social protection along with climate mitigation polices toward an aging world.

Building on firm foundations: Organizations and growth in urban arts communities

ABSTRACT This paper examines changes in the size of the nonprofit arts sector in mid-sized U.S. cities over the period from 2012 to 2019. Asking why some cities have more robust arts organizations than other cities, and why some see more organizational growth over time than others, the paper analyzes data collected on 223 mid-sized municipalities. I find that organizational capacities both within and beyond the arts sector strongly predict the size and growth of a city’s arts organization. Those capacities are measured by the presence of Fortune 500 firms, local arts councils, and successful applications for NEA grants. The findings also suggest that cities with greater income inequality have larger nonprofit arts sectors.

Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand

BackgroundThis study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients.MethodsData were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates.ResultsAmong 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles.ConclusionsThis study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap.

Why is greater income inequality associated with lower life satisfaction and poorer health? Evidence from the European Quality of Life Survey, 2012

ABSTRACT Greater income inequality is associated with lower average wellbeing. There are multiple possible explanations for this pattern. We use data from the European Quality of Life Survey 2012 (27,571 respondents from 28 countries) to evaluate the contributions of different causal pathways to associations between national income inequality and wellbeing. In unadjusted analyses, greater income inequality was associated with lower life satisfaction and poorer self-rated health. For life satisfaction, 43% of the association was attributable to individual income effects, and 41% to worse public services (especially access to healthcare). The association between income inequality and self-rated health was mainly (68%) due to individual income effects. For life satisfaction but not self-rated health, we found some evidence of costs of inequality that fall on those with high incomes. We conclude that the negative associations between income inequality and wellbeing across European countries are substantially, but not entirely, due to individual income effects.

The effect of nonpharmaceutical interventions on COVID-19 infections for lower and middle-income countries: A debiased LASSO approach.

This paper investigates the determinants of COVID-19 infection in the first 100 days of government actions. Using a debiased LASSO estimator, we explore how different measures of government nonpharmaceutical interventions affect new infections of COVID-19 for 37 lower and middle-income countries (LMCs). We find that closing schools, stay-at-home restrictions, and contact tracing reduce the growth of new infections, as do economic support to households and the number of health care workers. Notably, we find no significant effects of business closures. Finally, infections become higher in countries with greater income inequality, higher tourist inflows, poorly educated adults, and weak governance quality. We conclude that several policy interventions reduce infection rates for poorer countries. Further, economic and institutional factors are important; thereby justifying the use, and ultimately success, of economic support to households during the initial infection period.

Vital Signs: Drug Overdose Deaths, by Selected Sociodemographic and Social Determinants of Health Characteristics - 25 States and the District of Columbia, 2019-2020.

Drug overdose deaths increased approximately 30% from 2019 to 2020 in the United States. Examining rates by demographic and social determinants of health characteristics can identify disproportionately affected populations and inform strategies to reduce drug overdose deaths. Data from the State Unintentional Drug Overdose Reporting System (SUDORS) were used to analyze overdose death rates from 2019 to 2020 in 25 states and the District of Columbia. Rates were examined by race and ethnicity and county-level social determinants of health (e.g., income inequality and treatment provider availability). From 2019 to 2020, drug overdose death rates increased by 44% and 39% among non-Hispanic Black (Black) and non-Hispanic American Indian or Alaska Native (AI/AN) persons, respectively. Significant disparities were found across sex, age, and racial and ethnic subgroups. In particular, the rate in 2020 among Black males aged ≥65 years (52.6 per 100,000) was nearly seven times that of non-Hispanic White males aged ≥65 years (7.7). A history of substance use was frequently reported. Evidence of previous substance use treatment was lowest for Black persons (8.3%). Disparities in overdose deaths, particularly among Black persons, were larger in counties with greater income inequality. Opioid overdose rates in 2020 were higher in areas with more opioid treatment program availability compared with areas with lower opioid treatment availability, particularly among Black (34.3 versus 16.6) and AI/AN (33.4 versus 16.2) persons. Health disparities in overdose rates continue to worsen, particularly among Black and AI/AN persons; social determinants of health, such as income inequality, exacerbate these inequities. Implementation of available, evidence-based, culturally responsive overdose prevention and response efforts that address health disparities impacting disproportionately affected populations are urgently needed.

Greater income inequality, lower school belonging: Multilevel and cross-temporal analyses of 65 countries.

Greater income inequality, lower school belonging: Multilevel and cross-temporal analyses of 65 countries.

The impact of fossil fuel subsidies on income inequality: accounting for the interactive roles of corruption and economic uncertainty

PurposeThe aim of this empirical study is to examine the determinants of income inequality with particular concentration on the impact of fossil fuel subsidies, while controlling for corruption, economic uncertainty and democratisation in developing nations.Design/methodology/approachGeneralised method of moments (GMM) is the principal method used in this study due to time and cross-sectional dimensions of the series under observation. Augmented mean group (AMG) method has been used as an alternative estimator.FindingsThe results revealed that increase in fossil fuel subsidies causes greater income inequality. The results indicate that corruption and uncertainty aggravate the impact of fossil fuel subsidies on inequality. The results are not materially different when an alternative estimation technique is used to estimate the regressions.Research limitations/implicationsThis study uses data for 31 developing countries. So, with availability of more datasets in the future, further studies can include more countries in their analyses.Practical implicationsPrice reforms resulting in a major decrease in the fossil fuel subsidies is needed in these developing countries. The authorities must ensure that fiscal savings, structural adjustment and enhanced efficiency in production resulting from energy price reforms serve as catalyst to promote income distribution in these countries.Originality/valueThe author’s first addition to the literature is that the study has concentrated on the fossil fuel subsidies and income inequality relationship, which has not been sufficiently treated in the existing literature. Without adequately knowing the key factors determining income inequality, it may be difficult to use appropriate programmes that will safeguard appropriate income distribution.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-11-2021-0675

Remembering where we're from: Community- and individual-level predictors of college students' White privilege awareness.

Scholars in the field of community psychology have called for more research dedicated to examining White privilege as part of a system of White supremacy in the United States. One branch of this work focuses on awareness of White privilege, yet to date, this research has typically investigated awareness of White privilege at individual levels of analysis instead of also focusing on neighborhoods, schools, and other levels of analysis beyond the individual. In this study, we combine survey and U.S. Census data to explore both individual- and community-level predictors of White privilege awareness. With a sample of 1285 White college students, we found that gender, modern racism, social dominance orientation, and subjective socioeconomic status (SES) significantly predicted White privilege awareness. After accounting for these individual-level variables, we found that characteristics of students' hometowns (defined by zip code) predicted White privilege awareness. Specifically, greater income inequality was associated with higher White privilege awareness, while greater White racial homogeneity was marginally associated with lower White privilege awareness. There was a significant interaction between community-level White racial homogeneity and individual-level subjective SES, such that students with high subjective SES and low White racial homogeneity had the highest White privilege awareness. This study highlights the importance of examining different facets of ecological context in relation to White Americans' racial attitudes.

Lack of awareness of the HPV vaccination campaign among Brazilian students: a multilevel analysis

The scope of this article is to analyze the association between lack of awareness of the HPV vaccination campaign among Brazilian adolescents and individual and contextual factors. It involved a cross-sectional study with data from the National Student Health Survey (2015). Bivariate analysis was performed and Prevalence Ratios were calculated, in a multilevel Poisson Regression (95%CI) to verify the effect of variables on the outcome. The outcome was significantly associated with being 15-19 years old (PR=1.36), studying during the afternoon/night shift (PR=1.05), having already had sexual intercourse (PR=1.10), with self-perceived poor or very poor health status (PR=1.23), dissatisfied (PR=1.14) or indifferent (PR=1.15) regarding their body image, playing truant from classes without parental consent (PR=1.10) and studying at a public school (PR=1.24). There was less prevalence of the outcome among females (PR=0.24) and in states with greater income inequality (PR=0.80). The lack of awareness about the HPV vaccination campaign among adolescents was associated with individual characteristics, the context of the school and the unit of the federation. These findings indicate the importance of enhancing health promotion for vulnerable young people.

Energy poverty and income inequality: An economic analysis of 37 countries

Identifying those who are vulnerable to energy poverty is important to sustainable development, for which vulnerability is known as the inability to access an adequate level of energy services in the home. Although many studies have investigated the determinants of energy poverty at the household level, none has examined how these determinants can change according to a country’s economic situation. We use original survey data of 37 countries at various economic levels to address this issue by creating objective and subjective indicators in three dimensions: accessibility, reliability, and affordability. We employ a three-level hierarchical model to investigate how a country’s economic development level and income inequality, as well as household-level socioeconomic factors, affect households’ energy poverty. We find that energy poverty for country-average households shows an improving trend with economic development in the accessibility and reliability dimensions, while affordability is the worst in countries with a middle level of economic development and greater income inequality. Although it is well known that low household income is linked to worse energy poverty in affordability dimension, our findings add new insight that a higher economic development level and larger income inequality are the most relevant factors in the strong negative association, not climate conditions. We reveal that in addition to country-level factors, several household-level socioeconomic factors are associated with energy poverty in different ways depending on the dimension, which implies that customized criteria are necessary to define vulnerable households in each dimension.

Individual and Community Social Determinants of Health and Recovery from Alcohol Use Disorder Three Years following Treatment

ABSTRACT Prior research on recovery from alcohol use disorder (AUD) has often focused on individual-level factors that promote recovery. Given systemic health inequities, it is also important to study community-level social determinants of health (SDOH) that may promote recovery from AUD. This study extended prior work examining individual profiles of recovery from AUD to assess how individual and community SDOH at the time of treatment entry were associated with recovery from AUD three years after treatment. Data were utilized from the COMBINE study (n = 664), a multisite randomized clinical trial evaluating pharmacological and behavioral treatments for AUD. Public community data sources associated with participants’ study sites were used to measure community SDOH. Multilevel latent profile analyses with individual- and community-level variables as predictors of recovery profiles were estimated. Four profiles were identified based on participants’ alcohol consumption and functioning. Individual SDOH variables, such as fewer years of education and lower income, and community SDOH, including lower rates of health insurance, lower income, and greater income inequality, were each associated with lower functioning profiles. The findings highlight the importance of community SDOH in AUD recovery and the value of including both individual and community SDOH variables in research on long-term recovery.

Reward crowdfunding campaigns: Time-to-success analysis

The time-to-success of reward crowdfunding campaigns constitutes a relevant topic that has been neglected in business literature. In this study, we employ parametric and semi-parametric models of survival analysis to identify the determining factors of the duration of success of these campaigns. Based on more than 4200 reward crowdfunding campaigns, our results are robust for controls and reveal that the campaigns that attain success most rapidly are located predominantly in cities with greater income inequality. These are cities that are characterized by lower fundraising targets and receive a larger number of pledges. In addition, our covariates indicate a non-constant influence on time-to-success during the fundraising period.