High Status Groups Research Articles

Stress and the stability of social systems: A review of neurophysiological research

ABSTRACTCurrent societies are characterised by unprecedented change in demographic, economic and political terms. These changes may be rather stressful, especially for those who have most to lose, that is members of (formerly) high-status groups. In this contribution, we review research on the influence of hierarchy stability on physiological stress, making a distinction between the cardiovascular correlates of negative stress (“threat”) and positive stress (“challenge”). Results from six studies reveal that when hierarchies are stable those low in rank show threat, while when hierarchies are unstable, those high in rank show threat and those low in rank show challenge. These effects occur independently of whether rank is based on power or status, or on interpersonal or inter-group comparisons. Results are discussed in terms of theories on power and identity, and implications for (interventions for) inter-group conflict and health.

HEALTH MEDICAL EXAMINATION AND THE PREVALENCE OF METABOLIC SYNDROME

Background and Objective
 Metabolic syndrome (MetS) can be effectively prevented and treated by following healthy lifestyle practices. Healthy lifestyle management not only includes regulation of drinking and smoking, and regular physical activity but also health medical examinations. However, health medical examinations at private medical facilities involve high cost, limiting continuous and regular examination. The aim of this study is to analyze the prevalence of MetS and health management behavior according to the number of health medical examinations conducted in 14 years.
 
 Material and Methods
 According to the number of health medical examinations undertaken each year from 1999 to 2012, in 2012, 21,803 visitors (14,511 men and 7,292 women) from a health medical examination center at a private medical facility were assigned to low- (3–5 health examinations in 14 years), middle- (6–10 health examinations in 14 years), and high-frequency groups (11–14 health examinations for 14 years) and were classified by sex. Namely, they were divided into three groups: those who underwent 3–5 examinations, as low-frequency group, 6–10 examinations, as middle-frequency group, and 11-14 examinations, as high-frequency group. MetS was evaluated according to the criteria of the National Cholesterol Education Program and Adult Treatment Panel III and waist circumference was measured according to the standard for Asians by the World Health Organization. Odds ratio (OR) was calculated by logistic regression analysis.
 
 Results
 Systolic blood pressure tended to decrease to 124.5 versus 123.9 versus 123.5 mmHg in the low-, middle-, and high-frequency groups in men, respectively. In addition, the middle- and high-frequency groups demonstrated better total cholesterol, high-density lipoprotein, low-density lipoprotein, and systolic blood pressure compared with the low-frequency group. The prevalence of MetS demonstrated no significance before adjusting for variables in men, and high-frequency examinees demonstrated 18% low OR values (0.823, p < 0.001) after adjusting for age. OR was 0.868 (p = 0.015) when adjusted for age, other socio-economic factors, and health behavior. In women, the prevalence of MetS demonstrated significantly high OR of 1.205 (p = 0.007) and 1.300 (p = 0.008) in the middle- and high-frequency groups, respectively, but OR value decreased by 21% (0.791, p = 0.026) after adjusting for age. However, OR remained significant when adjusting for socioeconomic variables, physical activity, drinking, and smoking. For income and education, high-frequency examinees belonged to the high socioeconomic status group among men and women, but there were significant differences in walking among men with regard to physical activity (p < 0.001). Smoking was well-managed in the high-frequency group among men and women, and drinking showed a significant difference only in women (p < 0.001).
 
 
 Conclusion
 The high frequency of health medical examinations demonstrated low prevalence of MetS in men and women, and high socioeconomic status was associated with healthy behavior.
 
 
 

Give Them Fish or Teach Them to Fish? The Effects of Stability of Social Stratification and Forms of Help on Higher Socioeconomic Status Group Members’ Attitudes Towards Anti-Poverty Programs-CORRIGENDUM

Give Them Fish or Teach Them to Fish? The Effects of Stability of Social Stratification and Forms of Help on Higher Socioeconomic Status Group Members’ Attitudes Towards Anti-Poverty Programs-CORRIGENDUM

Give Them Fish or Teach Them to Fish? The Effects of Stability of Social Stratification and Forms of Help on Higher Socioeconomic Status Group Members’ Attitudes Towards Anti-Poverty Programs

Building on social identity approach and intergroup helping as status relations model, the current research examined the explored effects of stability of social stratification and forms of help on higher socioeconomic status (SES) members’ attitudes towards anti-poverty programs. Two studies were conducted in a 2 (social stratification stability) × 2 (forms of help) design on willingness to support anti-poverty programs. Study 1 examined the conditions of unstable and stable social stratification that might pattern differences in support of hypothetical anti-poverty programs construed as dependency-oriented or autonomy-oriented help. Study 2 replicated and extended study 1 by examining higher SES (subjective) participants’ attitudes towards the cash transfer programs (conditional vs. unconditional, which were determined by their perceptions of the stability of social stratification). Overall, the results of the two studies confirmed that attitudes towards anti-poverty programs could be construed as specific forms of help (dependency-oriented and/or autonomy-oriented help) depending on the nature of the intergroup relations (stability of the social stratification). Finally, the theoretical contribution of the current research is discussed.

How do you self-categorize? Gender and sexual orientation self-categorization in homosexual/heterosexual men and women

Group status influences individuals' identity. Low-status group members identify with their in-group more strongly than high-status group members. However, previous research has mostly analyzed explicit identification with a single in-group.We examined effects of both double group membership, namely gender and sexual orientation, which are two intersecting categories defining high/low-status groups, and contextual identity prime on both implicit self-categorization and explicit identification. Heterosexual and homosexual men and women (N=296) completed measures of implicit self-categorization and explicit identification with gender and sexual orientation after being primed with gender or sexual orientation. Implicit self-categorization was stronger for low-status than high-status groups: implicit gender self-categorization was higher for women than men, and implicit sexual orientation self-categorization was stronger for homosexual than heterosexual participants. Lesbian participants showed the strongest implicit sexual orientation self-categorization compared to the other three groups. Moreover, homosexual men and women and heterosexual women showed stronger implicit self-categorization with their low- than high-status membership. By contrast, heterosexual men showed equally strong implicit self-categorization with gender and sexual orientation. No differences on explicit identification emerged. Hypotheses on contextual identity primes were only partially confirmed. Findings are discussed in relation to literature about sexual orientation self-categorization and gender stigma.

When intergroup apology is not enough: Seeking help and reactions to receiving help among members of low status groups

AbstractRelations between groups are characterized by competition and suspicion. As a consequence, members of low status groups may question the meaning of apologies offered by a high status group, especially under unstable status relations. In two experiments, the present research investigated the role of the intergroup versus interpersonal apology and the potential moderating effect of the stability of intergroup relations on low status group members' (a) help seeking (Study 1) and (b) responses to receiving help (Study 2) from a high status group. Consistent with our hypotheses, when status relations were unstable rather than stable, following a formal intergroup relative to an interpersonal apology by an Israeli official, Israeli‐Arab students sought less dependency‐oriented and more autonomy‐oriented help from an Israeli‐Jewish study coordinator (Study 1) and Jewish‐Ethiopian newcomers reacted more negatively when they read about an Ethiopian‐Jewish student receiving unsolicited dependency‐oriented help from an Israeli‐Jewish college student (Study 2). Theoretical and practical implications are discussed.

Exploring perceptions of alcohol use in two Indian states: A qualitative study from Delhi and Haryana, India

Arora, M., Tewari, A., Bassi, S., Chauhan, K., Bhasin, S., Bakshi, A., & Andréasson, S. (2017). Exploring perceptions of alcohol use in two Indian states: A qualitative study from Delhi and Haryana, India. The International Journal Of Alcohol And Drug Research, 6(1), 1-6. doi:http://dx.doi.org/10.7895/ijadr.v6i1.238Aims: To explore perceptions and determinants influencing alcohol consumption, with a view to inform development of suitable policies to control alcohol consumption.Methodology: Focus group discussions (FGDs) (n=24) were conducted in two Indian states among the rural Haryana (n=8 FGDs; 58 participants) and urban Delhi (n=16 FGDs; 113 participants) populations. Purposive sampling was used to recruit the participants, who were from high and low socioeconomic status (SES) groups and in the age group of 18–58 years.Results: Different factors influence alcohol consumption in high and low SES groups. The age of initiation is now as low as 10–12 years, attributable to the recent trend of increased accessibility. The participants agreed that alcohol consumption has now become a more acceptable part of daily living, whereas earlier it was limited to special occasions and festivals. This has contributed to an increase in drinking. Drinking among women was earlier a taboo, but now women (mainly of high SES), are often seen drinking at social gatherings. The respondents mentioned weak enforcement of regulatory policies related to alcohol consumption and sales.Conclusions: A shift in attitudes was observed towards drinking. Drinking is increasingly seen as a part of daily life. The availability of alcohol is perceived to be increasing and restrictions on sale are not effectively enforced. There is an urgent need to re-evaluate the alcohol policy from a public health perspective in India.

Exploring perceptions of alcohol use in two Indian states: A qualitative study from Delhi and Haryana, India

Arora, M., Tewari, A., Bassi, S., Chauhan, K., Bhasin, S., Bakshi, A., & Andréasson, S. (2017). Exploring perceptions of alcohol use in two Indian states: A qualitative study from Delhi and Haryana, India. The International Journal Of Alcohol And Drug Research, 6(1), 1-6. doi:http://dx.doi.org/10.7895/ijadr.v6i1.238Aims: To explore perceptions and determinants influencing alcohol consumption, with a view to inform development of suitable policies to control alcohol consumption.Methodology: Focus group discussions (FGDs) (n=24) were conducted in two Indian states among the rural Haryana (n=8 FGDs; 58 participants) and urban Delhi (n=16 FGDs; 113 participants) populations. Purposive sampling was used to recruit the participants, who were from high and low socioeconomic status (SES) groups and in the age group of 18–58 years.Results: Different factors influence alcohol consumption in high and low SES groups. The age of initiation is now as low as 10–12 years, attributable to the recent trend of increased accessibility. The participants agreed that alcohol consumption has now become a more acceptable part of daily living, whereas earlier it was limited to special occasions and festivals. This has contributed to an increase in drinking. Drinking among women was earlier a taboo, but now women (mainly of high SES), are often seen drinking at social gatherings. The respondents mentioned weak enforcement of regulatory policies related to alcohol consumption and sales.Conclusions: A shift in attitudes was observed towards drinking. Drinking is increasingly seen as a part of daily life. The availability of alcohol is perceived to be increasing and restrictions on sale are not effectively enforced. There is an urgent need to re-evaluate the alcohol policy from a public health perspective in India.

Class matters: the sociolinguistics ofgooseandgoatin Manchester English

AbstractThis paper reports on patterns of sociolinguistic variation and change in Manchester'sgooseandgoatvowels on the basis of the acoustic analysis of 122 speakers, stratified by age, gender, socioeconomic status, and ethnicity.Goosefronting is an internal change showing little social differentiation, except before /l/ as inschoolandpool, where, in contrast to most other dialects of English,gooseshows advanced fronting inversely correlated with socioeconomic status.Goatfronting, on the other hand, is a change brought from outside the dialect by the highest status groups, displaying a pattern of monotonic social stratification, a female lead, and a strong effect of ethnicity. The role of attitudes toward the community in the realization of the vowels is compared with the effect of social class construed in terms of distances between social groups. Social class turns out to be a better predictor, suggesting that the role of attitudes and identity may be overestimated in research eschewing a systematic exploration of social class at the same time.

Socio‐economic differentials in cannabis use trends in Australia

To test if the degree of change in cannabis use between 2001 and 2013 differed according to socio-economic status. Repeated cross-sectional household surveys that were nationally representative. Australia. Adult samples from the 2001 and 2013 National Drug Strategy Household Surveys (n=23 642 in 2001 and n=21 353 in 2013), the largest nationally representative survey on drug use in Australia. Frequency of cannabis use coded as daily use, weekly use, less than weekly use and non-current use; socio-economic status (SES) as measured by personal income and educational level. There were significant differences in changes to levels of cannabis use between SES groups. Among participants who completed high school, the probability of daily use decreased from 0.014 to 0.009 (P<0.001), and the probability of weekly use decreased from 0.025 to 0.017 (P<0.001). These probabilities remained stable for participants who did not complete high school. The probability of weekly cannabis use decreased from 0.032 to 0.023 among participants with middle level income (P=0.004), and from 0.021 to 0.013 among those with high income (P=0.005). There were no significant changes in these probabilities among those with low income (0.026 in 2001 and 0.032 in 2013; P=0.203). The decline in cannabis use in Australia from 2001 to 2013 occurred largely among higher socio-economic status groups. For people with lower income and/or lower education, rates of frequent cannabis use remained unchanged.

Fuming with rage! Do members of low status groups signal anger morethan members of high status groups?

Owuamalam, Weerabangsa, Karunagharan and Rubin found that Malaysians associate people in low status groups with anger more than their higher status counterparts: the hunchback heuristic. But is this belief accurate? Here, we propose the alternative possibility that members of low-status groups might deliberately suppress anger to counter this stigma, while members of high-status groups might disinhibit their anger to assert their superiority. To test these propositions, we manipulated undergraduate students' relative group status by leading them to believe that provocative comments about their undergraduate social identity came from a professor (low-status condition) or a junior foundation year student (high-status condition). Using eye-tracking, we then measured their gaze durations on the comments, which we used as a physiological signal of anger: dwelling (Experiment 1). Results revealed that dwelling was significantly greater in the high-status condition than in the low-status condition. Experiment 2 conceptually replicated this pattern using a self-report method and found that the suppression-disinhibition effect occurred only when reputational concerns were strong.

To The Manner Born: How Earned Status And Inherited Status Influence Conformity

How status affects conventionality is a question with a long tradition in sociology and organization theory. The bulk of this literature focuses on how “earned status”, that is the status that is acquired through recognition and deference by peers or audiences, affects actors’ conventionality. Literature in social psychology has shown however, that actors also inherit status on the basis of ascribed characteristics (such as gender or nationality). We investigate how the inconsistency between the status actors earn and the status they inherit affect their propensity to adopt conventional choices. We suggest, as we detail in our study, that the status inconsistency for low-status actors from a high-status group prompts a different behavior than status inconsistency for high-status actors from a low-status group. We study the role of status inconsistency on the repertoire choice of conductors of the major US orchestras between 1896 and 1970. We find that high status conductors from low status countries are more likely, than their peers from high status countries, to play compositions that are more adopted in the field. As different from this, low status actors from high status countries are more likely to play unconventional compositions than their peers from low status countries.

Socioeconomic Differences in and Predictors of Home-Based Palliative Care Health Service Use in Ontario, Canada.

The use of health services may vary across people with different socioeconomic statuses, and may be determined by many factors. The purposes of this study were (i) to examine the socioeconomic differences in the propensity and intensity of use for three main home-based health services, that is, home-based palliative care physician visits, nurse visits and personal support worker (PSW) hours; and (ii) to explore the determinants of the use of home-based palliative care services. A prospective cohort study was employed. A total of 181 caregivers were interviewed biweekly over the course of the palliative care trajectory, yielding a total of 994 interviews. The propensity and intensity of health service use were examined using logistic regression and negative binomial regression, respectively. The results demonstrated that both the propensity and intensity of home-based nurse and PSW visits fell with socioeconomic status. The use of home-based palliative care services was not concentrated in high socioeconomic status groups. The common predictors of health service use in the three service categories were patient age, the Palliative Performance Scale (PPS) score and place of death. These findings may assist health service planners in the appropriate allocation of resources and service packages to meet the complex needs of palliative care populations.

Ideology and the maintenance of group inequality

This article discusses the role that ideology plays in justifying and perpetuating group-based inequality. We begin by defining and describing status ideologies and their characteristics. We then review research illustrating how endorsing or rejecting status-legitimizing ideologies influences group stereotyping, group differences in perceived entitlement, and perceptions of discrimination. We next discuss how people respond to threats to their status ideology, affectively, cognitively, physiologically, and behaviorally. We close by considering the role of ideology in how high status groups respond to changes in the status hierarchy.

Clinical profile of patients with atrophic rhinitis: descriptive study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Atrophic rhinitis is a chronic nasal disease, characterized by a triad of symptoms, namely foul odour, atrophy of nasal mucosa and crusts formation. The understanding of the pathophysiology and the management of atrophic rhinitis has long been a vexing problem for the treating clinician&lt;span lang="EN-IN"&gt;. Hence some authors have recommended adopting a capsular dissection technique in order to avoid these complications. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This present study was conducted in the Department of E.N.T, in which all the cases diagnosed as primary atrophic rhinitis and who were willing to undergo this surgery during the study period were taken for the study. Totally 20 patients were included for the study. Patients with secondary atrophic rhinitis were excluded&lt;span lang="EN-IN"&gt;. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In our study foul smelling nasal discharge and falling of crusts were the most commonest presenting symptoms which were present in all 20 patients (100%). The other presenting complaints were loss of sense of smell in 19 patients (95%), nasal obstruction in 16 patients (80%), bleeding from nose in 9 patients (45%), headache in 9 patients (45%) and maggots in 2 patients (10%)&lt;span lang="EN-IN"&gt;. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The incidence of atrophic rhinitis is more in low, less in middle and nil in high socio economic status group of patients and smelling nasal discharge and falling of crusts were the most commonest presenting symptoms&lt;span lang="EN-IN"&gt;.&lt;/span&gt;&lt;/p&gt;

A study on the Relationship of the weight pattern with the socioeconomic status among adolescents school going children in an Indian Metropolitan City

Objective: The last two decades have witnessed an increase in health care costs due to obesity and related issues among children and adolescents. Childhood obesity is a global phenomenon affecting all socio-economic groups, irrespective of age, sex or ethnicity. The study was done to find the the prevalence of obesity and overweight and their association with socioeconomic status (SES) and the risk factors. Materials and Methods: School based cross sectional study carried out over a period of 4 months in three schools of East Delhi. The study was carried out in 629 school children of 10–18 years of age and belonging to different socioeconomic statuses in schools in East Delhi. The obesity and overweight were considered using an updated body mass index reference. A pre-tested questionnaire was used to determine the Socio-economic status and life style factors. Results: The prevalence of overweight among children was higher in middle socioeconomic status groups as compared to high socioeconomic class in both boys and girls whereas the prevalence of obesity was higher in high Socio economic status group as compared to middle socioeconomic group. The prevalence of obesity as well as overweight in low SES group was the lowest as compared to other group. Conclusion: The findings of this study suggest that the prevalence of overweight and obesity varies remarkably with different socioeconomic development levels.

Conceptualizing the Spectrum of the Bereavement Discourse

This article presents the spectrum of the bereavement discourse, namely, how various social groups interpret the loss of their children’s lives or the potential risk to their lives posed by their military service and translate it into public discourse, as a spectrum of attitudes. It is argued that this spectrum ranges from subversive to submissive approaches. Furthermore, within the confines of the declining casualty tolerance, two variables cumulatively determine the actors’ choice of discourse: the level of enforcement of recruitment, ranging from conscription to voluntary recruitment, and the social position of the group to which the agents belong. Given that conscription brings powerful, high-status groups into the ranks who may be unwilling to make sacrifices for war, subversive responses are more likely to occur in conscript militaries than in volunteer forces and vice versa. This article maps this spectrum and hypothesizes about its determinants.

The Counter-Normative Effects of Service-Learning: Fostering Attitudes toward Social Equality through Contact and Autonomy

Power dynamics are implicated in prosocial behavior (Nadler & Halabi, 2015). This research investigated two factors that influence the effect of prosocial behavior on views of social equality: amount of direct contact and type of helping. Students in a social psychology course (N = 93) were randomly assigned to a service-learning group or to a control group. The service-learning group was further subdivided into an autonomy-oriented helping group or a dependency-oriented helping group. After participating in approximately 19 hours of community service over nine weeks, service-learners had more positive views of social equality compared to the control group. This effect was strongest in autonomy-oriented helpers who had high levels of direct contact. The implications and mechanisms of service-learning as a form of counter-normative prosocial behavior are discussed. Prosocial behavior is an integral, adaptive component of human functioning. Prosocial behavior can take many forms, including spontaneous assistance offered in emergencies, sustained community service, and the billions of dollars given each year in philanthropy. Communities richly benefit from the time, resources, and talents of prosocial people. Prosocial behavior also benefits helpers. Prosocial people become happier, healthier, and experience a greater sense of purpose in life through their service to others (Piliavin, 2003; Smith & Davidson, 2014). Prosocial behavior that is intergroup (i.e., that occurs across different social groups) has the added potential benefit of increasing people's exposure to diverse group members and may result in an increased preference for social equality. Brown (2011a, 2011b) found that participating in service-learning, a form of prosocial behavior (IPB), reduced social dominance orientation (Pratto, Sidanius, Stall worth, & Malle, 1994). Social dominance orientation is an anti-egalitarian attitude that includes one's preference for group-based social hierarchy and support for discrimination against lower status groups (Sidanius & Pratto, 1999). The conditions under which these benefits of prosocial behavior are most likely to accrue have not yet been explored. The present study examines two variables hypothesized to influence the relationship between IPB and attitudes toward social equality: the amount of direct, personal contact that groups have with one another and the type of assistance offered. We begin with a brief review of the literature to provide the theoretical context for this study's design and hypotheses, focusing on the intimate relationship between IPB and power. Power dynamics are frequently implicated in IPB. The group offering assistance (i.e., the helpers) may possess some resource that the other group (i.e., the recipients) lacks, and thus the transaction is founded on a status differential. The Intergroup Helping as Status Relations Model (IHSR; Nadler, 2002; Nadler & Halabi, 2006) is the most well-developed theory in social psychology to describe the connection between IPB and power dynamics. The model is based on the assumption that pervasive legitimation of social inequality (Costa-Lopes, Dovidio, Pereira, & Jost, 2013) operates within IPB, such that rather than promote equality, prosocial behavior frequently serves the ironic function of keeping high status and low status groups in their respective places (Cunningham & Platow, 2007; Halabi, Dovidio, & Nadler, 2008; Jackson & Esses, 2000; Nadler & Chernyak-Hai, 2014). The IHSR differentiates between two types of prosocial behavior: autonomy-oriented and dependency-oriented. Autonomy-oriented helping is aimed at assisting the recipient to help him or herself by providing a partial solution such as tools that can be used to resolve the issue or need. In contrast, dependency-oriented helping provides a full solution to the recipient's need. …

The Dynamics of Compensation: When Ingroup Favoritism Paves the Way for Outgroup Praise.

Compensation research suggests that when people evaluate their own and another group, the search for positive differentiation fuels the emergence of compensatory ratings on the two fundamental dimensions of social perception, competence and warmth. In two experiments, we tested whether obstacles to positive differentiation on the preferred dimension disrupted compensation. Both experiments showed that high-status (low-status) group members grant the outgroup a higher standing on warmth (competence) when positive differentiation can be achieved on the orthogonal dimension, competence (warmth). Moreover, and in line with the " noblesse oblige" effect, Experiment 2 confirmed that, among high-status group members, perceived higher pressures toward nondiscrimination were linked to outgroup bias on warmth only when ingroup bias on competence had been secured. The discussion focuses on compensation as one of the factors contributing to cooperative intergroup relations.

Investigating socio-economic inequity in access to and expenditures on routine immunization services in Anambra state

BackgroundAddressing existing inequities in the utilization of priority health services such as routine immunization is a current public health priority. Increasing access to routine immunization from the current low levels amongst all socio-economic status groups in Nigeria is challenging. However, little is known on the level of SES inequity in utilization of routine immunization services and such information which will inform the development of strategies for ensuring equitable provision of routine immunization services in the country. The study was a cross sectional household survey, which was undertaken in two randomly selected communities in Anambra State, southeast Nigeria. A pre-tested interviewer administered questionnaire was used to collect data on levels of access to RI by children under-2 years from randomly selected households. In each household, data was collected from the primary care givers or their representative (in their absence). The relationship between access to routine immunization and socio-economic status of households and other key variables was explored in data analysis.ResultHouseholds from high socio-economic status (well-off) groups utilized routine immunization services more than those that belong to low socio-economic status (poor) groups (X2 = 9.97, p < 0.002). It was found that higher percentage of low socio-economic status households compared to the high socio-economic status households received routine immunization services at public health facilities. Households that belong to low socio-economic status groups had to travel longer distance to get to health facilities consequently incurring some transportation cost. The mean expenditures on service charge for routine immunization services (mostly informal payments) and transportation were US$1.84 and US$1.27 respectively. Logistic regression showed that access to routine immunization was positively related to socio-economic status and negatively related to distant of a household to a health facility.ConclusionAbility to pay affects access to services, even when such services are free at point of consumption with lower socio-economic status groups having less access to services and also having other constraints such as transportation. Hence, innovative provision methods that will bring routine immunization services closer to the people and eliminate all formal and informal user fees for routine immunization will help to increase and improve equitable coverage with routine immunization services.