Indicators Of Social Inequality Research Articles

Perceived discrimination in health care in Germany– results of a population survey

BackgroundIt has consistently been shown that perceived discrimination is associated with adverse health outcomes. Despite this uncontested relevance, there is a lack of research on the experiences of discrimination in health care. Therefore, the following research questions were addressed: (1) How often do people in Germany report having been discriminated in health care due to different reasons? (2) Which socio-demographic groups are most afflicted by perceived discrimination in health care?MethodsAnalyses are based on a cross-sectional online survey conducted in Germany. An adult population sample was randomly drawn from a panel which was recruited offline (N = 2,201). Respondents were asked whether they have ever been discriminated in health care due to the following reasons: age, sex/gender, racism (i.e. migration history, religion, language problems, colour of skin), health issues or disability (i.e. overweight, mental illness/addiction, disability), socio-economic status (SES, i.e. income, education, occupation).Results26.6% of the respondents reported discrimination experiences. Perceived discrimination due to health issues or disability was most frequent (15%), followed by age (9%) and SES (8.9%). Discrimination due to racism and sex/gender was less frequently reported (4.1% and 2.5%). Younger age groups, women, and 2nd generation migrants as well as respondents with low income and low education were more likely to report any kind of discrimination in health care. Two groups were found to be at special risk for reporting discrimination in health care across different reasons: women and younger age groups. Discrimination due to racism was more prevalent among respondents who have immigrated themselves than those who were born in Germany but whose parents have immigrated. Discrimination due to SES was significantly associated with (low) income but not with education.ConclusionsMore than a quarter of the adult population in Germany reported experiences of discrimination in health care. Such experiences were more frequent among lower SES groups, migrants, women, and younger people. Results underline the necessity of interventions to reduce the magnitude and consequences of discrimination in health care. Future studies should apply an intersectional approach to consider interactions between social inequality indicators regarding discrimination and to identify risk groups that are potentially afflicted by multiple discrimination.

Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru.

The aim of this study was to evaluate the rates of fetal mortality in a Peruvian hospital between 2001 and 2020 and to investigate the association of indicators of social inequality (such as access to prenatal care and education) with fetal mortality. We conducted a retrospective cohort study, including all pregnant women who attended a Peruvian hospital between 2001 and 2020. We collected data from the hospital's perinatal computer system. We used Poisson regression models with robust variance to assess the associations of interest, estimating adjusted relative risks (aRR) and their 95% confidence intervals (95% CI). We analyzed data from 67,908 pregnant women (median age: 26, range: 21 to 31 years). Of these, 58.3% had one or more comorbidities; the most frequent comorbidities were anemia (33.3%) and urinary tract infection (26.3%). The fetal mortality ratio during the study period was 0.96%, with the highest rate in 2003 (13.7 per 1,000 births) and the lowest in 2016 (6.1 per 1,000 births), without showing a marked trend. Having less than six (aRR: 4.87; 95% CI: 3.99-5.93) or no (aRR: 7.79; 6.31-9.61) prenatal care was associated with higher fetal mortality compared to having six or more check-ups. On the other hand, higher levels of education, such as secondary education (aRR: 0.73; 0.59-0.91), technical college (aRR: 0.63; 0.46-0.85), or university education (aRR: 0.38; 0.25-0.57) were associated with a lower risk of fetal death compared to having primary education or no education. In addition, a more recent year of delivery was associated with lower fetal mortality. Our study presents findings of fetal mortality rates that are comparable to those observed in Peru in 2015, but higher than the estimated rates for other Latin American countries. A more recent year of delivery was associated with lower fetal mortality, probably due to reduced illiteracy and increased access to health care between 2000 and 2015. The findings suggest a significant association between indicators of social inequality (such as access to prenatal care and education) with fetal mortality. These results emphasize the critical need to address the social and structural determinants of health, as well as to mitigate health inequities, to effectively reduce fetal mortality.

Mind the Gap… But Which Gap? The Distinctions Between Social Inequalities in Student Achievement

AbstractInternational large-scale assessments have revealed social inequalities in achievement in almost all countries, reporting achievement gaps between socioeconomic status groups, by immigration background and by gender. However, there has been little research on whether individual countries show smaller or larger gaps across all three different social categories, or whether the gaps corresponding to these categories are independent of each other. This article explores the degree to which social inequality can be understood as one umbrella concept, or whether different categories of social inequality are substantially different concepts. Using the OECD’s Programme for International Student Assessment 2018 results in Mathematics in 76 countries, the study observes the correlation between the three achievement gaps across countries, and compares how each achievement gap is associated with some typical country-level covariates. Several results are highlighted. First, the size and direction of the immigration and gender gaps vary across countries; most countries present achievement gaps in favor of boys and native students, but this direction is reversed in several countries. Second, there is hardly any correlation between the three achievement gaps. One education system may be egalitarian in one category, but profoundly unequal in another. Third, this lack of correlation is also related to how we study these inequalities, as the results show that each achievement gap is associated with a different set of institutional features. To properly assess how unequal or egalitarian education systems are, researchers and interested parties need to consider and address different indicators of social inequality.

Relationship between microcephaly and indicators of social inequality in the state of Paraíba, Brazil.

• Seventy-four (33.18%) municipalities in the state of Paraíba registered live births with microcephaly. • The highest proportion of cases (23.03%) was concentrated in the capital, João Pessoa. • Number of inhabitants, number of cases of Zika virus, water supply, and average household income were associated with a higher proportion of new cases. To analyze the relationship between microcephaly and social inequality indicators in the state of Paraíba during the biennium January 2015 and December 2016. Ecological study with data from newborn microcephaly records and municipal socioeconomic, environmental, and demographic indicators was conducted using two health information systems from the Brazilian Ministry of Health (SINASC and SINAN) and the Brazilian Institute of Geography and Statistics. A Poisson multiple regression model was applied with a significance level of 5%. Among 223 municipalities in Paraíba, 74 registered new cases of microcephaly. The number of Zika virus cases, number of inhabitants, number of households without adequate water supply, and household income were predictor variables of the number of new cases of microcephaly in Paraíba. Microcephaly is associated with indicators of social inequality in Paraíba. Zika virus cases, water supply, and family income are the indicators that best explain the increase in microcephaly cases. Therefore, these variables must be monitored by health professionals and authorities.

The association of social inequality with the onset, persistence, and progression of psychotic experiences along the extended psychosis phenotype: a 6-year follow-up study in a community-based sample.

This paper aims to investigate associations between early childhood and current indicators of socioeconomic inequality and the onset (incident), persistence and progression (increase in severity) of psychotic experiences (PEs) in a longitudinal follow-up of a community-based population. Households in the metropolitan area of Izmir, Turkey were contacted in a multistage clustered probability sampling frame, at baseline (T1, n = 4011) and at 6-year follow-up (T2, n = 2185). Both at baseline and follow-up, PEs were assessed using Composite International Diagnostic Interview 2.1. The associations between baseline socioeconomic features and follow-up PEs were analysed using logistic regression models. Indicators of social inequality included income, educational level, current socioeconomic status (SES), social insurance, the area resided, ethnicity, parental educational level, and SES at birth. The risk of onset of PEs was significantly higher in lower education, lower SES, and slum-semi-urban areas. The persistence of PEs was significantly associated with the lowest levels of education and current SES, and rural residency. Persistent PEs were significantly and negatively associated with paternal SES at birth. Progression of PEs was significantly higher among respondents with educational achievements lower than university level and lower levels of SES, who have no social insurance and who reside in slum-semi-urban areas. Parental education and paternal SES at birth were not associated with the persistence of PEs. Indicators of social inequality (low education, low SES, low income, and poverty in the neighbourhood) were associated with the onset and persistence of PEs and progression along the extended psychosis phenotype. The early indicators seem to have a modest life-long impact on the psychosis phenotype.

Food and Nutrition Surveillance System (SISVAN) coverage, nutritional status of older adults and its relationship with social inequalities in Brazil, 2008-2019: an ecological time-series study.

to analyze the temporal trend of Food and Nutrition Surveillance System (Sistema de Vigilância Alimentar e Nutricional - SISVAN) coverage and the nutritional status of older adults, and its correlation with indicators of social inequality in Brazil between 2008-2019. this was an ecological study using records from SISVAN, related to the population aged 60 years and older; the temporal trend of coverage and the correlation between indicators of social inequality and increment rate of nutritional status were analyzed; slope index of inequality and concentration index were used to measure absolute and relative inequalities. 11,587,933 records were identified; national coverage increased from 0.1% (2008) to 2.9% (2019), with a statistically significant upward trend; a moderate inverse correlation with an annual increment rate of overweight between human development index and gross domestic product per capita, was found. there was an increasing trend in SISVAN coverage; the increase in overweight was associated with social inequality.

Cobertura do Sistema de Vigilância Alimentar e Nutricional (SISVAN), estado nutricional de idosos e sua relação com desigualdades sociais no Brasil, 2008-2019: estudo ecológico de série temporal

Abstract Objective: to analyze the temporal trend of Food and Nutrition Surveillance System (Sistema de Vigilância Alimentar e Nutricional - SISVAN) coverage and the nutritional status of older adults, and its correlation with indicators of social inequality in Brazil between 2008-2019. Methods: this was an ecological study using records from SISVAN, related to the population aged 60 years and older; the temporal trend of coverage and the correlation between indicators of social inequality and increment rate of nutritional status were analyzed; slope index of inequality and concentration index were used to measure absolute and relative inequalities. Results: 11,587,933 records were identified; national coverage increased from 0.1% (2008) to 2.9% (2019), with a statistically significant upward trend; a moderate inverse correlation with an annual increment rate of overweight between human development index and gross domestic product per capita, was found. Conclusion: there was an increasing trend in SISVAN coverage; the increase in overweight was associated with social inequality.

Мода: эстетические и социальные функции

The unity and interrelation of aesthetic and social components of fashion from the standpoint of philosophy is emphasized. The boundaries of the concept of «fashion» are clarified from the point of view of modern science, in relation to which its aesthetic and social functions were analyzed – fashion in the broad sense of the word, in other words, not only vestigial – related to the style of clothing. An excursion into the history of fashion as a marker of social inequality and an indicator of social inequality with attention to the gender aspect of this issue is carried out. The modern problems of the interpenetration of aesthetic and social as fashion changes are touched upon. Much attention is paid to sources related to the Internet, mass media, advertising. It is concluded that in the context of fashion, aesthetics helps society and individuals to build a particular system of views, while society, through certain value attitudes, acquires certain aesthetic ideas.

Social Inequalities: Do They Matter in Asthma, Bronchitis, and Respiratory Symptoms in Children?

Background: Social inequalities (e.g., poverty and low level of education) generate inequalities in health. Aim: The aim of the study was to determine the relationships between indicators of social inequalities and the frequency of respiratory symptoms, asthma, and bronchitis in children. Material and Methods: In 2019, an epidemiological cross-sectional study on 3237 students from elementary schools in Silesia Voivodships (South Poland) was conducted. The students' parents completed a questionnaire based on the International Study on Asthma and Allergies in Childhood (ISAAC). Social inequalities in the children's families were determined according to parents' education and professional status (working vs. unemployed), self-assessment of economic status, and housing conditions. To determine the influence of social factors on the occurrence of asthma, bronchitis, and respiratory symptoms, the odds ratio (OR) was calculated. Results: Children living in apartments with traces of mold had a higher risk of developing asthma (OR = 1.5, 95%CI: 1.17-1.96; p = 0.002) or bronchitis (OR = 1.4, 95%CI: 1.13-1.72; p = 0.002), wheezing attacks at nights (OR = 1.4; 95%CI: 1.01-1.93), wheezy in the last 12 months (OR = 1.6; 95%CI:1.24-2.08; p < 0.001), and chronic cough (OR = 1.9; 95%CI: 1.49-2.46; p < 0.001). Exposure to environmental tobacco smoke (ETS) was associated with higher risk of cough (OR = 1.5 95%CI: 1.22-1.96; p < 0.001) and dyspnea in the last 12 months (OR = 1.4; 95%CI: 1.04-2.00; p = 0.02). Low socioeconomic status (SES) was associated with increased risk of chronic cough (OR = 1.5; 95%CI: 1.09-2.03; p = 0.009) and increased risk of wheezy in the last 12 months (OR = 1.4; 95%CI: 1.06-1.97; p = 0.008). Asthma and bronchitis were not dependent on parents' education or professional status. Conclusions: Social inequalities have significant impacts on the occurrence of respiratory symptoms, bronchitis, and asthma in children. Interventions aimed at preventing bronchitis and childhood asthma should also focus on social health determinants.

Determinants of mammography screening participation-a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS).

We investigated the association between social inequality and participation in a mammography screening program (MSP). Since the German government offers mammography screening free of charge, any effect of social inequality on participation should be due to educational status and not due to the financial burden. The 'Gutenberg Health Study' is a cohort study in the Rhine-Main-region, Germany. A health check-up was performed, and questions about medical history, health behavior, including secondary prevention such as use of mammography, and social status are included. Two indicators of social inequality (equivalence income and educational status), an interaction term of these two, and different covariables were used to explore an association in different logistic regression models. A total of 4,681 women meeting the inclusion criteria were included. Only 6.2% never participated in the MSP. A higher income was associated with higher chances of ever participating in a mammography screening (odds ratios (OR): 1.67 per €1000; 95%CI:1.26-2.25, model 3, adjusted for age, education and an interaction term of income and education). Compared to women with a low educational status, the odds ratios for ever participating in the MSP was lower for the intermediate educational status group (OR = 0.64, 95%CI:0.45-0.91) and for the high educational status group (0.53, 95%CI:0.37-0.76). Results persisted also after controlling for relevant confounders. Despite the absence of financial barriers for participation in the MSP, socioeconomic inequalities still influence participation. It would be interesting to examine whether the educational effect is due to an informed decision.

Changes of Self-Rated Health Status, Overweight and Physical Activity During Childhood and Adolescence-The Ratchet Effect of High Parental Socioeconomic Status.

Childhood and adolescence are important life periods for the development of health status and physical activity (PA) behaviours. This study analyses the stability and potential changes of self-rated health status, overweight and PA behaviour over time, specifically focusing on the age and the socioeconomic status of children and adolescents. We employ representative longitudinal data for German children and adolescents from the Motorik-Modul Study and the German Health Interview and Examination Survey. Using four different dichotomous health status and PA indicators (self-rated health status [SRHS]; overweight; moderate-to-vigorous PA; and leisure sports engagement), we report within-person transition rates across the panel waves when the survey was taken (2003–2006, 2009–2012, and 2014–2017). Additionally, we report results of logistic regressions estimating the impact of children's age, gender, migration background, and their parents' socioeconomic status on these transition rates. The transition rates show mixed results. While children and adolescents from highly problematic states reporting bad SRHS and no leisure sports engagement at an early stage tend to improve later on, overweight children mostly stay overweight. Age and social inequality indicators correlate with some of the chances of improving or worsening the health and PA states. Most clearly, high parental status prevents the health status and PA from worsening over all transitions, particularly becoming overweight, representing a ratchet effect. The results of the present study underline that health policy needs to target specific groups to reduce social inequality in the health status and PA of children and adolescents.

Quarantots, quarankids, and quaranteens: how research can contribute to mitigating the deleterious impacts of the COVID-19 pandemic on health behaviours and social inequalities while achieving sustainable change.

The adoption and maintenance of healthy behaviours including age-appropriate amounts of physical activity, limited sedentary and screen time, and healthy eating are the foundations for youth development and thriving. In reviewing extant evidence, we observe that the COVID-19 pandemic has been associated with marked reductions in physical activity, increased sedentary and screen time, and increased food intake and unhealthy snacking. Deleterious effects in movement behaviours appear to be more pronounced among vulnerable groups and food insecurity has become more widespread. To contribute to mitigating these impacts, we advocate for strengthened evidence-based public health. Towards this end, ongoing surveillance should be intensified and augmented with additional indicators of social inequalities. More importantly, substantial efforts must be devoted to developing, implementing, and evaluating complex interventions aimed at equitably promoting recommended 24-hour movement behaviours and healthy eating guidelines in home, childcare, school, and neighbourhood settings.

Is high-speed rail socially exclusive? An evidence-based worldwide analysis

The extent to which high-speed rail (HSR) could be socially egalitarian has been disregarded, despite evidence that upper social-occupational groups are the primary users of high-speed trains (HSTs). In this context, this review aims to fill the gap by investigating the social attributes of HSR passengers based on worldwide, available ex post data derived from surveys at both national and corridor levels. The study’s results converge to conclude that HSR passengers are predominantly male, higher income, highly educated and belonging to higher social-occupational groups. Key indicators of social inequalities (i.e. income, occupational group and education) show a much sharper differentiation in HSR use than gender and age. Social inequalities arguably shape the uneven use of HSR through available income compared to HSR fares; through income compared to total expenditure on non-business travel; and through travel purposes, considering the high share of business travel aboard HSTs. Our findings highlight “greener” transport means and policies may not be socially inclusive. They also raise the issue of facilities (co-)funded by taxpayers that do not benefit the masses.

The Impact of Socio-Economic Position on Perceived Oppression: Using Social Support as a Mediator

Within the continuing economic downturn, our society has been facing rapid dichotomization and bi-polarization between groups which reinforces social inequality. Young (2011) states that social inequality should be viewed as a concept of oppression, not by the distribution of resources, which has been considered as a general indicator of social inequality. Following her argument, she suggests exploitation, marginalization, powerlessness, cultural imperialism, and violence as sub-concepts of oppression. In this sense, this study uses the distribution of resources as an independent variable and the ‘perceived oppression’ presented by Young as a dependent variable to identify the role of social support as a factor that makes the difference between social-structural inequality and contextual inequality. Through hierarchical regression analyses and bootstrapping methods this paper looks at how the two different perspectives on inequality are related, and how the social support mediates the relationship between socio-economic position and perceived oppression. By shedding light on the meaning of socio-economic isolation of individuals, this study will contribute to the academia in searching for the alternatives to strengthen the stability of our society where the new paradigm of communication is being used to form network ties and corresponding sense of supports.

Social variations in pregnancy outcomes in Murmansk county-one of the Northernmost European provinces

Abstract Background Pregnancy outcomes are widely used indicators of population wellbeing varying both between and within countries. The aim of this study was to assess social variations in preterm births and term small-for-gestation-age (SGA) infants in the Northernmost provinces of Europe - the Murmansk region - using the data from the first Russian population-based birth registry. Methods A registry-based study of 52 806 births in the Murmansk region for a 5-year period was performed. We studied the prevalence and social determinants of moderate-to-late preterm births (MLPTB, 224-258 days of gestation), very preterm births (VPTB, 196-223 days) and extremely preterm births (EPTB, 154-195 days) and term SGA for both weight and length births (SGAWL). Associations between social factors and pregnancy outcomes were studied by multivariable logistic regression. Results The prevalence of PTB was 6.9 with EPTB, VPTB and MLPTB constituting 0.3%, 0.6% and 6.0%, respectively. A total of 4.1% of infants were SGAWL. Women with primary, secondary and vocational education were 1.59 (95%CI:1.22-1.85), 1.33 (95%CI:1.20-1.48), 1.19 (95%CI:1.22-1.85) times more likely to have MLPTB than women with higher education. Corresponding values for VPTB were 1.65 (95%CI:0.88-3.08), 1.41 (95%CI:1.02-1.95) and 1.27 (95%CI:0.92-1.75), respectively. Single and cohabiting women had significantly elevated risk for MLPTB (ORs=1.47 (95%CI:1.30-1.66) and 1.39 (95%CI:1.26-1.44)) and VLPTB (ORs=2.00, 95% CI: 1.42-2.81 and 1.32, 95% CI: 0.97-1.79) compared to married women. Unmarried mothers were more likely to have SGAWL boys (OR = 1.60, 95% CI: 1.38-1.86) and SGAWL girls (OR = 1.51, 95%CI:1.31-1.76) compared to married women. Conclusions We observed significant social variations in pregnancy outcomes by maternal education and marital status in the Murmansk region. Registry data can be used as an effective tool for monitoring inequalities in pregnancy outcomes as indicators of social inequalities. Key messages We found significant social variations in pregnancy outcomes in the Northernmost province of Europe - the Murmansk county (Russia). Birth registry data can be used for monitoring of health inequalities in Russia.

Relationship between social inequality indicators and the spatial distribution of Zika Virus cases.

The aim of this article was to analyze the possible relationship between social inequality indicators and the spatial distribution of ZIKV cases in a state in Northeastern Brazil in 2015-16. This is an ecological study with the data of notified ZIKV cases and the sociodemographic indicators of Rio Grande do Norte state (RN), based on information from the State Public Health Department (SESAP-RN) and DATASUS. The data were analyzed in Terraview version 4.2.2, Geoda version 1.12 and IBM SPSS Statistics 21. Both the average incidence rate (AIR) of ZIKV cases in 2015-16 (Moran = 0.139; p= 0.03) and the AIR of violence (Moran= 0.295; p= 0.02), average household income (Moran= 0.344; p=0.01) and unemployment rate (Moran= 0.231; p=0.01) exhibited a geographic spatial distribution pattern. In multiple linear regression analysis, the variables AIR of violence and average household income explained 55% of the variation in the AIR of ZIKV in 2015-16 (adjusted R2 = 0.55). Municipalities with more notifications of violence and higher average income, such as the state capital, reported a higher number of ZIKV cases, possibly due to better organization, greater awareness of socioenvironmental problems and easier access to health services.

Comparative Analysis of Poverty and Social Inequality Indicators in the Constituent Entities of the Russian Federation as a Criterion of National Economic Security

Comparative Analysis of Poverty and Social Inequality Indicators in the Constituent Entities of the Russian Federation as a Criterion of National Economic Security

Social inequality and mental health

Social inequality refers to the inequitable distribution of social prosperity including the resource of health. The relationship between social inequality and mental health can be established by means of indicators of social inequality throughout all age groups in Germany. There are social gradients of mental health on the population level, i.e. the linear relationship between social classes or status and state of health. Fundamental determinants of health disparity are cultural, social, political, and geographical conditions, which interact with the genetic make-up and epigenetic processes. These determinants also influence the management of developmental tasks during the life course and are of utmost importance for the development of mental disorders. The maladaptation to chronic stress is at the core of health disparity. Interventions at the individual behavioral level should comprise the development of stress management and coping strategies.

Social patterning in Indonesian adolescent smoking: A mediation analysis of family smoking, parental control, and parental permissiveness

Objective: In poorer communities, smoking has demonstrated as an indicator of social inequalities in mortality. Adolescents from poor family are often exposed to smoking and are more vulnerable to ...

СИСТЕМА ОБРАЗОВАНИЯ И СОЦИАЛЬНОЕ НЕРАВЕНСТВО: АНАЛИЗ ЗАРУБЕЖНЫХ ПОДХОДОВ К ИССЛЕДОВАНИЮ ПРОБЛЕМЫ

Международный опыт реформирования системы образования свидетельствует о значительных проблемах социального неравенства в получении услуг образования. Существующее неравенство доходов – индикатор социального неравенства образовательных возможностей. Объект исследования: система образования развитых стран. Предмет исследования: неравные возможности в получении образования. Показано, что различия между странами в уровне образования граждан коррелируют с разнообразием мест проживания и неравенством доходов домохозяйств. Доступность образования и преодоление социального неравенства является необходимым компонентом социально-экономического и культурного развития общества. Образование является инструментом установления равенства граждан. Имея высшее образование, гражданин может изменить социальное положение и уровень доходов. Однако, в современном мире институт образования не только усугубляет социальное неравенство, но и закрепляет разделение общества на социальные слои. Анализ зарубежных подходов позволил определить тенденцию углубления социального неравенства; в мировом сообществе, ориентирующемся на модель глобального образования, изменения в доступности обучения средним и низшим слоям населения не произошло.Цель: выявить, по материалам существующей литературы, подходы к анализу социального неравенства в системе образования в зарубежных странах.Метод и методология проведения работы: использовался сравнительный метод исследования методической, аналитической, социологической, педагогической литературы по изучению международного опыта реформирования системы образования и возникающим проблемам социального неравенства. Исследование основывалось на опыте, представленном в международных публикациях сборников научных статей и научно-методических периодических изданиях.Результаты: выявлена корреляционная связь между неравенством доходов, разнообразием мест проживания и уровнем образования.Область применения результатов: международный образовательный опыт может быть использован Россией, входящей в мировое образовательное пространство и меняющей образовательную политику на всех уровнях образования, с целью объединения усилий по преодолению общей проблемы социального неравенства.