Inequalities In Attendance Research Articles

Attendance at remote versus in-person outpatient appointments in an NHS Trust.

With the growing use of remote appointments within the National Health Service, there is a need to understand potential barriers of access to care for some patients. In this observational study, we examined missed appointments rates, comparing remote and in-person appointments among different patient groups. We analysed adult outpatient appointments at Imperial College Healthcare NHS Trust in Northwest London in 2021. Rates of missed appointments per patient were compared between remote versus in-person appointments using negative binomial regression models. Models were stratified by appointment type (first or a follow-up). There were 874,659 outpatient appointments for 189,882 patients, 29.5% of whom missed at least one appointment. Missed rates were 12.5% for remote first appointments and 9.2% for in-person first appointments. Remote and in-person follow-up appointments were missed at similar rates (10.4% and 10.7%, respectively). For remote and in-person appointments, younger patients, residents of more deprived areas, and patients of Black, Mixed and 'other' ethnicities missed more appointments. Male patients missed more in-person appointments, particularly at younger ages, but gender differences were minimal for remote appointments. Patients with long-term conditions (LTCs) missed more first appointments, whether in-person or remote. In follow-up appointments, patients with LTCs missed more in-person appointments but fewer remote appointments. Remote first appointments were missed more often than in-person first appointments, follow-up appointments had similar attendance rates for both modalities. Sociodemographic differences in outpatient appointment attendance were largely similar between in-person and remote appointments, indicating no widening of inequalities in attendance due to appointment modality.

Trends and Determinants of Intergenerational Educational Inequality in Sub-Saharan Africa for Birth Cohorts 1974 to 2003

This article expands the scope of comparative social stratification research in education to rapidly developing, largely low-income sub-Saharan Africa. First, we investigate trends in the association between parental socioeconomic status (SES) and children’s chances to attend and complete primary education, exploring whether and where educational expansion of the early twenty-first century led to equalization of educational opportunities. Drawing on data from 153 Demographic and Health Surveys and Multiple Indicator Cluster Surveys (1990–2017) from 40 countries, findings indicate that inequality in attendance declined, but inequality in completing six grades largely persisted. Cross-country analyses reveal a large variation in inequality levels and trends. We explore the role of national contextual factors and find that underweight prevalence, fertility rates, school fees, public spending on education, and the ratio of pupils to teaching staff systematically explain variation in SES gaps across countries and cohorts. Findings underline the importance of absolute material deprivation and school teaching resources in the stratification of educational opportunities in this region.

Vegetarianism without vegetarians: Caste ideology and the politics of food in India

Climate change debates have helped frame vegetarianism as a conscientious choice across the globe and also projected India as a shining example of vegetarianism. Before this Euro-American vegetarians had long romanticized India as an ideal vegetarian society, and have assumed it to be based on progressive ethics. This article challenges such assumptions and complicates the Euro-American association of vegetarian dietary preferences with the ethical concerns of virtue, animal welfare, and sustainability. We contend that neither is India a vegetarian society nor is mainstream vegetarianism in contemporary India based on progressive ethics. We use in-depth interviews and extensive news reports to show that vegetarianism in India is a majoritarian political ideology associated with caste-based discrimination and violence, making it inimical to notions of non-violence, equality, and freedom. Majoritarian vegetarianism in contemporary India aims to conserve the caste system and its attendant inequalities. This study traces the ideological and repressive state apparatuses through which the fantasy and norms of vegetarianism are propped up in contemporary India. We argue that an uncritical acceptance of mainstream vegetarianism in contemporary India as a benevolent cultural preference whitewashes its discriminatory and violent nature, helps the caste system persist, and can undermine the well-being and nutritional outcomes of a majority of the Indian population especially those from non-elite social groups that have historically been omnivorous.

Stigma and strategy in Pakistan's HIV prevention sector

AbstractNGOs often portray commercial sex workers, injecting drug users, transgender people (hijrae), and homosexual men as quasi‐legal persons who are locked in a policing‐criminality relationship with the state, and who therefore need them to mediate this relationship. By advancing such portrayals, NGOs in Pakistan's HIV prevention sector capitalize upon the presumed cultural difference of the so‐called risk groups of HIV. They appropriate stigma against these groups as a strategy to access funds and to fortify their own position as brokers in the unstable donor‐dominated funding landscape of HIV prevention. In doing so, the NGO leaders and members end up stabilizing stigma and reinforcing its attendant inequalities in the socially conservative environment of Pakistan. The discriminatory legal framework that criminalizes sex outside marriage and non‐therapeutic use of drugs goes unchallenged by NGOs, despite their apparent support for universal human rights, partly because the status quo stabilizes these organizations’ position as brokers between state and donor agencies and the so‐called risk groups of HIV.

The Immovable AMLO

The Immovable AMLO Humberto Beck (bio), Carlos Bravo Regidor (bio), and Patrick Iber (bio) Click for larger view View full resolution President Andrés Manuel López Obrador waves a flag on the balcony of the National Palace to kick off Independence Day celebrations on September 15, 2020, in Mexico City. (Hector Vivas/Getty Images) [End Page 92] When Andrés Manuel López Obrador was elected president of Mexico in 2018, he promised a government “for the good of all, with the poor coming first.” He pledged to break with neoliberalism and its attendant inequalities, violence, and corruption. After more than two years in power, AMLO remains rhetorically committed to a vision of equality. But he has pursued this vision with a set of very fixed ideas. As new challenges have emerged, he has not adapted. His inflexibility threatens to undermine the promise that his election represented. His government’s handling of the coronavirus is emblematic of this problem. When COVID-19 cases began to surface in Mexico last spring, AMLO’s response bordered on denial. A total lockdown would have been difficult to pull off in a country where a majority of the population earns a living from informal work. “I can’t stop working,” one hamburger vendor told reporters. “If I don’t sell, I don’t eat. It’s as simple as that.” But AMLO’s own activities demonstrated a lack of concern about spreading the virus. Initially, he made no changes to his practice of making trips around the country, which brought him into close contact with thousands of his supporters. He also promoted deadly misinformation. At the end of March, during one of his daily morning conferences, AMLO took out a pair of “amulets” and said that they would protect him and the country from the pandemic. Even after catching and recovering from COVID-19 in early 2021, AMLO chooses not to wear a mask in public. As the number of cases rose, the government suspended large public gatherings and in-person schooling but avoided imposing a mandatory lockdown. Inconsistent public messaging encouraged voluntary restrictions, asking Mexicans to maintain safe social distance. Despite many people having little choice but to keep working outside of their homes to survive, Mexico experienced an 8.5 percent reduction of its gross national product in 2020, its worst economic contraction in almost ninety years. In keeping with AMLO’s commitment to “republican austerity,” direct financial support has been minimal. Big business, he announced, had [End Page 93] evaded taxes and didn’t deserve support: “No more bailouts like those given to banks in the era of neoliberalism.” But AMLO’s government has offered little help to ordinary people either. Some benefits were dispersed early, but there was no large-scale effort to provide insurance or basic income to the millions who found themselves short of work. Mexico’s coronavirus relief spending remains among the stingiest in the world: less than 1 percent of GDP. That figure is dwarfed by the relief policies of other Latin American countries; Chile and Brazil’s relief packages, for instance, amounted to about 8 percent of GDP. The coronavirus has devastated Mexico. In September 2020, AMLO predicted that the worst was over. By the end of 2020, cases spiked, peaking in late January of this year. Black markets emerged for oxygen tanks, as family members tried to take care of sick relatives who could not, or would not, access public hospitals. According to data from the National Autonomous University of Mexico, somewhere between 18 and 55 million Mexicans (in a country of roughly 130 million) have contracted the virus. Mexico has the lowest rate of testing in the Americas and the highest positivity rate. By the end of February, the government reported approximately 185,000 deaths due to COVID-19. Mexico, with the world’s tenth-highest population, ranked third in the world for deaths, behind only the United States and Brazil. But looking at “excess deaths” compared to previous years reveals that official figures have grossly understated the cost to Mexico: by mid-December, there were already 380,000. After returning from his illness in early February, AMLO spoke optimistically about rolling...

A Biometric Logic of Revelation: Zach Blas’s <em>SANCTUM</em> (2018)

A Biometric Logic of Revelation: Zach Blas’s <em>SANCTUM</em> (2018)

Social gradients in dental attendance among older adults: Findings from the National Survey on Demographics and Health in Peru.

To assess the presence of inequalities in attendance to dental services in relation to socio-economic position (SEP) in a national sample of older adults in Peru. A cross-sectional study using multivariate regression analysis of secondary data obtained from the National survey on demographics and family health in Peru (Encuesta Nacional en Demografía y Salud familiar, ENDES). 4749 ≥60-year-olds. Attendance at dental health services in the last 2 years. Independent variable: Wealth Index as a measure of SEP. Covariates: Sex, age, natural region of residence, place of residence and health insurance coverage. There was a social gradient for the association between attendance to dental health services and SEP, with older adults from the richest (fifth) quintile showing a 3.01 times higher probability of visiting dental services (95%CI 2.15-4.19), those in the fourth quintile PR=2.19 (95%CI 1.61-3.00), third quintile PR=2.00 (95%CI 1.49-2.69), and those in the second quintile PR=1.42 (95%CI 1.10-1.84), when compared to the poorest quintile after adjusting for sex, age, residence, natural region and health insurance coverage. There is a clear social gradient in dental attendance among older adults in Peru. This is important to provide further insights into current national programmes and relevant long-term policies.

Sex, age and socioeconomic inequalities in older people’s unscheduled care

Abstract Background In Scotland, unscheduled care is usually received at hospital accident and emergency (A&E) departments or referral by GPs to medical assessment units (MAU). Almost a quarter attendances are for those aged 65 years+. Demand for unscheduled care will increase as the population ages. This study measures inequalities in unscheduled care presentations among those aged 65 years+. Methods A&E and MAU attendance data between April 2017 and March 2018 for Glasgow residents were analysed. Data were modelled using poisson modelling for outcome measures attendances, rate of attendance and length of stay, adjusting for agegroup, sex and deprivation. A second set of models also adjusted for time of day, month and referral source, including interaction terms. Results While there was a higher number of attendances among females (RR and 95% CI = 0.30 (0.28, 0.32)), and among those aged 65-69 years compared with older ages (RR = 0.03 (0.01, 0.06)), modelling rates showed that males were significantly more likely to attend (RR = 0.14 (0.13, 0.16)) and that likelihood rose with age, eg RR for 85+ years significantly greater than 80-84 years, significantly greater than for 75-79 years etc. There was no gender difference in length of stay but this increased with increasing age. Attendance was significantly more likely for those living in the most deprived quintile of deprivation (RR = 0.30 (0.27, 0.34) compared with the most affluent quintile). SES inequalities in attendance and length of stay became less pronounced with increasing age. Referrals via 999 emergency services increased with age while referrals by GP and NHS24 reduced with age. Attendance was more likely in December (RR = 0.15 (0.11, 0.18)) and likelihood of a morning attendance reduced significantly with increasing age and deprivation. Conclusions Inequalities in attendance, length of stay and methods of referral are observed which should be considered when planning to meet the demand for unscheduled care. Key messages Age, sex and socioeconomic inequalities in unscheduled care exist even at the oldest ages. When planning to meet the demand of future unscheduled care, patterns of current use and population projections should be considered in tandem.

Predictors and Trend in Attendance for Breast Cancer Screening in Lithuania, 2006-2014.

In Lithuania, a Nationwide Breast Cancer (BC) Screening Program was launched in 2005, offering mammography for women aged 50 to 69 years, every other year. This study aimed to determine the trend in the attendance for mammography screening during 2006–2014 and to identify the factors that are predictive for participation in it. The study sample consisted of 1941 women aged 50–64 years, who participated in five cross-sectional biennial postal surveys of Lithuanian Health Behavior Monitoring, carried out in independent national random samples. The attendance for screening was identified if women reported having had a mammogram within the last two years. The proportion of women attending the screening was continuously increasing from 20.0% in 2006 up to 65.8% in 2014. The attendance for BC screening was associated with the participation in cervical cancer screening. A higher level of education, living in a city, frequent contact with a doctor, and healthy behaviors (fresh-vegetable consumption, physical activity, and absence of alcohol abuse) were associated with higher participation rates in BC screening. To increase BC screening uptake and to reduce inequalities in attendance, new strategies of organized BC screening program using systematic personal invitations are required in Lithuania.

Socio-economic inequalities in ANC attendance among mothers who gave birth in the past 12 months in Debre Brehan town and surrounding rural areas, North East Ethiopia: a community-based survey

BackgroundIn Ethiopia, socio-economic inequalities in the utilization of antenatal care (ANC) have long been an obstacle to the country’s effort in achieving universal coverage of the service. The study aimed to investigate socio-economic inequalities in the use of ANC services among recently-delivered women in Debre Brehan and surrounding areas, North East Ethiopia.MethodsA community-based survey was carried out in Debre Brehan and surrounding areas in North East Ethiopia. Two-stage cluster sampling technique was followed to recruit study participants. Data was collected using interviewer-administered structured questionnaire from a sample of 412 mothers who gave birth in the 12 months prior to the study. The socio-economic inequalities were assessed by calculating a relative concentration index. Decomposition analysis was done to explain measured inequalities. Analysis was carried out in RStudio statistical environment using the ‘decomp’ package.ResultsThe first ANC attendance has slight pro-poor concentration, with a relative concentration index of-0.128, and 95%CI -0.175, − 0.082.Socio-Economic Status (SES) of a household, educational level and occupation of a woman and her husband were the most important contributors to the measured inequality in ANC attendance. We found no SES-based inequality in the attendance of four or more ANC visits between the poor and rich.ConclusionsAttendance of the first ANC visit appeared to be slightly concentrated among women in the lower end of SES. The utilization of at least four ANC visits was found to be similar among the poor and rich. Population-based interventions that target all socio-economic groups are recommended to accelerate universal coverage of these process indicators.

Access to grammar schools by socio-economic status

One of the main motivations given for the proposed new expansion of grammar schools in England is to improve social mobility. We assess the role of existing grammar schools in promoting social mobility by examining access to grammar schools, differentiating among the 85% non-poor pupils using the National Pupil Database. We find stark differences in grammar school attendance within selective areas by socio-economic status, even when comparing pupils with the same Key Stage 2 attainment. High attaining children from the most deprived backgrounds are significantly less likely to attend a grammar school compared to similarly high attaining children from the least deprived backgrounds. Given these large inequalities in attendance to grammar schools, conditional on achievement, it is hard to see how such a system would promote the aim of improving social mobility.

A systematic review of interventions using cue-automaticity to improve the uptake of preventive healthcare in adults: applications to dental visiting.

Since behaviour is underpinned by both cognitive and automatic processes, psychological interventions aiming to instigate or modify habitual behaviour (cue-automaticity interventions) offer an alternative to the more commonly used (mainly educational) strategies to increase preventive healthcare use. Theory suggests that low socio-economic (SES) groups are especially likely to benefit. Cue-automaticity describes how repetition of behaviour, initiated by a particular 'cue', in a constant context, leads to the automatic instigation and/or execution of behaviour. Our primary objective was to assess the effectiveness of cue-automaticity interventions to improve the uptake of adult preventive healthcare, and to consider how this might be applied to the design of interventions to promote preventive dental visiting. An electronic search, with citation snowballing, of cue-automaticity interventions to influence adult preventive healthcare use was undertaken. Searching identified 11,888 titles and abstracts. Paper screening left 26 papers, of which 6 RCTs met the inclusion criteria. All 6 incorporated an Implementation Intention (I-I) component. Four studies involved cancer screening and 2 involved vaccination programmes. Five studies showed a significantly positive increase in preventive healthcare use, while one did not. Whilst few studies using cue-automaticity to underpin the promotion of preventive care use have been undertaken, studies that do exist have promising results. As cue-automaticity interventions may be of particular benefit to low SES groups, research is needed to investigate whether cue-automaticity interventions can translate into reducing inequalities in attendance for dental check-ups.

Sociologists everywhere: Country representation in conferences hosted by the International Sociological Association, 1990–2012

Professional events that feature face-to-face interaction of social scientists from across the world are, next to publications and research, important forms of scientific knowledge production and dissemination. Thus, they are vital to the World Science System (WSS). Like other WSS elements, scholarly involvement in international social science events is characterized by unequal cross-national representation. This article focuses in-depth on the International Sociological Association (ISA), a major international social science professional association, to examine inequality in attendance at its flagship conferences. To what extent do countries differ with respect to the number of scholars attending ISA conferences? What factors drive attendance? The authors base their hypotheses on the economic, political and social dimensions that influence country representation. To test these hypotheses the authors use a dataset containing information on 212 countries and their participation in the eight ISA conferences – World Congresses and Forums – held from 1990 to 2012. Results show that a country’s GDP, level of democracy and social science research infrastructure (SSRI) substantially determine their level of representation. SSRI effects are significant above and beyond the effect of GDP and of other controls. Findings also show a meaningful over-time decrease in representation inequality according to countries’ GDP.

Sex Matters

Feminists increasingly recognize that “sex,” as a reference to embodied male–female difference, is no less socially constructed than “gender.” Like all signifiers, the meaning of these terms is produced through contingent and particular historical processes; yet histories of “how sex was made” are rare. This essay draws on extensive, multidisciplinary research – focused through a lens of early (archaic) state making – to render a partial and provisional genealogy of sex. The schematic history begins with early human social formations and the “agricultural revolution” that marked a shift from food gathering to food producing. It then reviews the defining characteristics – in particular, the invention of writing – and attendant inequalities of early/archaic state-formation (urbanization; the “rise of civilization”). The centralization of Greek city-states has particular, indeed profound, relevance for what is conventionally called the “western tradition.” The essay then directs attention to the Athenian polis, not only because it exemplifies features of early states, but because modern interpretations of classical texts and Athenian practices uniquely shaped European political theory/practice; in particular, by naturalizing hierarchies of gender, sexuality, ethnicity/race, class and national “difference.”

Does removal of out‐of‐pocket costs for cervical and breast cancer screening work? A quasi‐experimental study to evaluate the impact on attendance, attendance inequality and average cost per uptake of a Japanese government intervention

Reducing out-of-pocket costs is known to improve mammography attendance, but an evidence gap remains concerning Pap smear testing. The Japanese government implemented a politically determined intervention to remove out-of-pocket costs for Pap smear tests and mammography attendance, costing US$148 million, in 2009. It targeted women when they reached the first year of a 5-year age group (i.e., 20, 25, 30 years) with the aim of reducing attendance inequality. Our objective is to evaluate the intervention in terms of uptake and average cost per uptake for cancer screening attendance and to assess socioeconomic inequalities in cancer screening attendance pre- and postintervention. A quasi-experimental study utilizing national repeated cross sections, observed pre- and postintervention, which compared intervention and comparison groups by the Difference-in-Differences method, was conducted. Outcome measures were uptake of cancer screening attendance resulting from the intervention with average cost per uptake and broad inequality indicators for cancer screening attendance according to socioeconomic inequality. In total, 34,043 age-eligible, noninstitutionalized women were analyzed. Uptake among the overall population was 13.9% point in the age- and income-adjusted model for Pap smear and 9.8% point for mammography, with an average cost of US$139 per uptake. The intervention increased inequality indicators in Pap smear attendance (more than +100%) but decreased inequality in mammography attendance (ranging from -12.9 to -74.1%) within the intervention group. In conclusion, removing out-of-pocket costs improves female cancer screening uptake in Japan but may not be cost-saving. Although cost removal reduces inequalities in attendance for mammography, it appears to increase inequalities in Pap smear attendance.

Pro-Poor Progress in Education in Developing Countries?

Attendance in education and associated years of schooling have expanded substantially in developing countries in recent years. But has this expansion in enrolments reduced existing inequalities in educational access and achievements? This paper analyzes differences in improvements in the access to the education system and in educational outcomes across the welfare distribution between and within countries, and also by gender and regions for a sample of 37 developing countries using Demographic and Health Surveys (DHS). For the analysis, the toolbox of pro-poor growth analysis is applied to several educational indicators. We find drastic inequalities in educational attendance across the income distribution. Interestingly, inequalities in attendance declines with rising average attendance, while inequality in completion rates or schooling years increases with rising completion rates or schooling years.

Inequalities in attendance in organized early learning programmes in developing societies: findings from household surveys

While the importance of attending early learning programmes is increasingly evident, the provision of early learning programmes in developing countries has not grown in parallel. In this paper we examine how attendance in early learning programmes for children aged 3–6 years, the recommended period, differs within and across 52 developing countries. We use two household surveys, the Multiple Indicator Cluster Survey (MICS) and the Demographic and Health Survey (DHS). We employ logistic regression equations to predict the probability of attending early learning programmes. First, the participation rate varies extensively by age within the age range examined. Second, children with mothers with secondary education or higher and from the upper end of household wealth distribution have higher probabilities of attending early learning programmes. The findings highlight the need for disaggregated data and policies targeting children from disadvantaged family backgrounds in promoting early learning programmes.

Social class, ethnicity and attendance for antenatal care in the United Kingdom: a systematic review.

Evidence from outside the United Kingdom points to several socio-demographic factors associated with late initiation of antenatal care or fewer antenatal visits, but it is not clear how generalizable these studies are to the UK context. This systematic review addresses the question of whether there are social or ethnic inequalities in attendance for antenatal care in the United Kingdom. We identified and reviewed UK studies assessing attendance for antenatal care according to any measure of social class, social deprivation or ethnicity. A wide range of electronic databases was searched for published and unpublished studies. Further studies were identified from reference lists, citation searches and key organizations. From over 1300 identified papers, 20 were potentially relevant. Nine were included in the review. Most studies were of poor quality, with only one study controlling for the effect of potential confounders such as age, parity and clinical risk factors. All but one were based on data collected around 20 years ago. Three of the five studies looking at antenatal attendance and social class found that women from manual classes were more likely to book late for antenatal care and/or make fewer antenatal visits than other women. All four studies reporting on antenatal attendance and ethnicity found that women of Asian origin were more likely to book late for antenatal care than white British women. There is little good quality evidence on social and ethnic inequalities in attendance for antenatal care in the United Kingdom. Recommendations for further research are suggested.

Education and Social Class: Revisiting the 1944 Education Act with Fixed Marginals

Trends in class inequality in attendance at selective schools are hard to interpret, since the number of places at these schools and the distribution of children by class also change over time. Reanalysing data from the Nuffield Mobility Study, it is shown that interpretation of the trends depends on which measure of association is used. By viewing stratification as a continuous hierarchy which is then sliced up into « classes » of differing sizes, some interpretative problems can be overcome; greatest clarity is achieved by defining a top class equal in size to the number of selective school places. Reanalysing the data using this « fixed marginals » approach, a clear pattern emerges : growing inequality before 1944, movement towards equality in the first decade after, but sharply increased inequality thereafter. An explanation is proposed to explain this pattern

Influences of Women's Schooling on Maternal Behavior in the Third World

Previous articleNext article No AccessPart I. OverviewsInfluences of Women's Schooling on Maternal Behavior in the Third WorldRobert A. LeVineRobert A. LeVine Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Comparative Education Review Volume 24, Number 2, Part 2Jun., 1980Part 2, Women and Education in the Third World Sponsored by the Comparative and International Education Society Article DOIhttps://doi.org/10.1086/446140 Views: 5Total views on this site Citations: 28Citations are reported from Crossref Copyright 1980 The Comparative and International Education SocietyPDF download Crossref reports the following articles citing this article:Oyepeju Mary Onifade, Jesse Abiodun Otegbayo, Joshua Odunayo Akinyemi, Titus Ayodeji Oyedele, Ademola Richard Akinlade Nutritional status as a determinant of cognitive development among preschool children in South-Western Nigeria, British Food Journal 118, no.77 (Jul 2016): 1568–1578.https://doi.org/10.1108/BFJ-11-2015-0445Scott A. 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