Related Inequalities Research Articles

Role of inflammation in the socioeconomic inequalities of neurocognitive disorders

BackgroundSocioeconomic position has been shown to be associated with inflammation. However, little is known about the role of inflammation in socioeconomic inequalities in relation to neurocognitive disorders in later life and the potential underlying inflammatory mechanisms. This study has used longitudinal data to investigate the mediation effects of inflammation in the relationship between socioeconomic position and neurocognitive disorders in older adults. MethodsUsing data from the English Longitudinal Study of Ageing (ELSA, n = 4,815), we ascertained neurocognitive disorders using a recognised consensus criterion and included the following categories: (1) No Cognitive Impairment (NOCI) (2) Cognitive Impairment No Dementia (CIND) and (3) Dementia. We examined whether socioeconomic position (education, occupation, and wealth) measured in 2008/09 was associated with neurocognitive disorders measured in 2018/19. Mediation analyses were carried out to investigate the role of inflammatory markers [C-Reactive Protein (CRP), plasma fibrinogen and white blood cells (WBC)] in the association between socioeconomic inequalities and subsequent neurocognitive disorders. Sensitivity analyses were conducted to assess the mediating role of lifestyle behaviours and body mass index (BMI). ResultsHigher education, occupation and wealth were longitudinally associated with a lower likelihood of cognitive impairment and dementia. WBC mediated the association between latent socioeconomic position and CIND [β = -0.037 (CI: −0.06 to −0.01)], but not the association with dementia. Indirect effects were attenuated but remained significant when other mediators, such as lifestyle behaviours and BMI were considered. In a separate analysis accounting for main confounders, CRP and fibrinogen mediated the association between education and CIND, all three inflammatory biomarkers mediated the association of occupation and CIND, while WBC mediated the association between wealth and CIND. ConclusionThese findings emphasise that socioeconomic inequalities in mid and later life could contribute to the prevalence of neurocognitive disorders in later life. Our results provide some evidence for the biological embedding of WBC in the association between socioeconomic inequalities and cognitive impairment via elevated inflammation. Future studies should explore other plausible biological mechanisms.

Quantum speed limit and categorical energy relative to microlocal projector

Inspired by recent developments of quantum speed limit we introduce a categorical energy of sheaves in the derived category over a manifold relative to a microlocal projector. We utilize the tool of algebraic microlocal analysis to show that with regard to the microsupports of sheaves, our categorical energy gives a lower bound of the Hofer displacement energy. We also prove that on the other hand our categorical energy obeys a relative energy-capacity type inequality. As a by-product this provides a sheaf-theoretic proof of the positivity of the Hofer displacement energy for disjointing the zero section [Formula: see text] from an open subset [Formula: see text] in [Formula: see text], given that [Formula: see text].

Social inequalities in mental and physical health derived from the COVID-19 pandemic in Spain beyond SARS-CoV-2 infection

BackgroundUnderstanding the impact of the COVID-19 crisis on health involves conducting longitudinal studies to evaluate the inequalities that may have been exacerbated by the pandemic. The purpose of this study was to estimate differences in physical and mental health derived from the COVID-19 pandemic, beyond SARS-CoV-2 infection, in the Spanish general population according to the participants’ level of education; and to assess the evolution of these differences from June 2020 (just after the lockdown) to nine months later (February-March 2021).MethodsThis is a longitudinal prospective study of a representative sample of non-institutionalized Spanish adults, through computer-assisted telephone interviews. Mobility, self-care, usual activities, pain/discomfort and anxiety/depression problems were measured with EQ-5D-5L. Prevalence ratio (PR) between high and low education levels and adjusted PR were estimated by Poisson regression models. Analyses were stratified by gender.ResultsA total of 2,000 participants answered both surveys. Individuals with low level of education reported more health problems in both genders, and absolute inequalities remained quite constant (mobility and self-care problems) or decreased (pain/discomfort and anxiety/depression problems). The greatest relative inequalities were observed just after the lockdown, with age-adjusted PR ranging from 1.31 (95%CI 1.08–1.59) for women and 1.34 (95%CI 1.05–1.69) for men in pain/discomfort to 2.59 (95%CI 0.98–6.81) for women and 4.03 (95%CI 1.52–10.70) for men in self-care; aPR decreased after nine months for most dimensions.ConclusionsPrevalence of health problems increased during the COVID-19 pandemic in all education groups, but the increase was higher in women and men with a high level of education, suggesting that its impact appeared later in this group. Further analysis on the role of governmental economic aid given to vulnerable people might shed light on this evolution.

Support for and potential impacts of key Smokefree 2025 strategies among Māori who smoke.

The recently passed Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Act has the potential to profoundly reduce smoking prevalence and related health inequities experienced among Māori. This study examined support for, and potential impacts of, key measures included within the legislation. Data came from Wave 1 (2017-2019) of the Te Ara Auahi Kore longitudinal study, which was conducted in partnership with five primary health organisations serving Māori communities. Participants were 701 Māori who smoked. Analysis included both descriptive analysis and logistic regression. More Māori participants supported than did not support the Smokefree 2025 (SF2025) goal of reducing smoking prevalence to below 5%, and the key associated measures. Support was greatest for mandating very low nicotine cigarettes (VLNCs). Participants also believed VLNCs would prompt high rates of quitting. Participants who had made more quit attempts or reported less control over their life were more likely to support VLNCs. There was support for the SF2025 goal and for key measures that could achieve it. In particular, VLNCs may have significant potential to reduce smoking prevalence among Māori. As part of developing and implementing these measures it will be important to engage with Māori who smoke and their communities.

Lucky Numbers and Greedy Ghosts: Lottery as Trope for the Singapore Dream

Abstract This article analyzes Singaporean films on the topic of the state-sponsored lottery as trope for the national dream, focusing on three different categories: popular films that link lottery winnings to the state’s promise of economic prosperity; hor-medy (horror/comedy) films that depict characters who are punished by the ghosts for greed; and art films that depict social inequalities in relation to unsuccessful efforts to attain the national dream. In doing so, it examines what Lee Kah-Wee refers to as the “relationship between morality and economics within the context of nation-building” with respect to Singaporean film. The convergence of cinematic treatment of lottery cultures between otherwise separate popular films, horror films, and arthouse films is a unique commonality in Singapore film. Also, films discussed in this paper from the late 1990s to 2013 reflect the ongoing centrality of lottery films in Singaporean cinema and the national imaginary.

Prevalence of smoking during pregnancy and associated social inequalities in developed countries over the 1995-2020 period: A systematic review.

Smoking during pregnancy (SDP) is an important source of preventable morbidity and mortality for both mother and child. The aim of this study was to describe changes in the prevalence of SDP over the last 25 years in developed countries (Human Development Index >0.8 in 2020) and associated social inequalities. A systematic review was conducted based on a search in PubMed, Embase and PsycInfo databases and government sources. Published studies between January 1995 and March 2020, for which the primary outcome was to assess the national prevalence of SDP and the secondary outcome was to describe related socio-economic data were included in the analysis. The selected articles had to be written in English, Spanish, French or Italian. The articles were selected after successive reading of the titles, abstracts and full-length text. An independent double reading with intervention of a third reader in case of disagreement allowed including 35 articles from 14 countries in the analysis. The prevalence of SDP differed across the countries studied despite comparable levels of development. After 2015, the prevalence of SDP ranged between 4.2% in Sweden and 16.6% in France. It was associated with socio-economic factors. The prevalence of SDP slowly decreased over time, but this overall trend masked inequalities within populations. In Canada, France and the United States, the prevalence decreased more rapidly in women of higher socio-economic status, and inequalities in maternal smoking were more marked in these countries. In the other countries, inequalities tended to decrease but remained significant. During pregnancy, that is a period described as a window of opportunity, smoking and social vulnerability factors need to be detected to implement targeted prevention strategies aiming at reducing related social inequalities.

Persistence of severe global inequalities in the burden of blindness and vision loss from 1990 to 2019: findings from the Global Burden of Disease Study 2019

AimsTo assess the global burden and economic inequalities in the distribution of blindness and vision loss between 1990 and 2019.MethodsA secondary analysis of the Global Burden of Diseases, Injuries and...

One-dimensional Barenblatt-type solutions and related inequalities

One-dimensional Barenblatt-type solutions and related inequalities

Relative energy inequality and weak-strong uniqueness for an isothermal non-Newtonian compressible fluid

Our paper deals with three-dimensional nonsteady Navier-Stokes equations for non-Newtonian compressible fluids. It contains a de­ri­va­tion of the relative energy inequality for the weak solutions to these equations. We show that the standard energy inequality implies the relative energy inequality. Consequently, the relative energy inequality allows us to achieve a weak-strong uniqueness result. In other words, we present that the weak solution of the Navier-Stokes system coincides with the strong solution emanated from the same initial conditions as long as the strong solution exists. For this purpose, a new assumption on the coercivity of the viscous stress tensor was introduced along with two natural examples satisfying it.

On convex functions and related inequalities

The main result of this paper is to give refinement and reverse the celebrated Jensen inequality. We directly apply our results to establish several weighted arithmetic-geometric mean inequality. We also present a stronger estimate for the first inequality in the Hermite-Hadamard inequality.

Customer Purchase Intention in a Local Fast Food Restaurant: Testing the Role of Social Media Marketing Activities

The main aim of this study was to investigate the role of social media marketing activities on customer purchase intention in a local fast food restaurant. The independent variabel used in this study is social media marketing activities and the dependent variabel used in this study is purchase intention. The intervening variables used are value equity, brand equity, and relationship equity. Necessary data was gathered from the followers of social media via a quantitative online survey. Using a self administrated questionnaire, 250 respondents were asked to answer the survey employing convenience sampling method. After obtaining the desired responses, the data was analyzed by the AMOS 24 structural equation modeling. The results indicated that for direct effects, social media marketing activities have positive and significant effects on value equity, brand equity, and relationship equity. The results also indicated that brand equity and relationship equity have positive and significant effects on purchase intention. Value equity has positive but not significant effect on purchase intention. Then social media marketing activities have negative direct effects on purchase intention. Meanwhile, for indirect effects, social media marketing activities don’t have significant effects on purchase intention through value equity. But social media marketing activities have moderate effects on purchase intention through brand equity. Finally, social media marketing activities have significant effects on purchase intention through relationship equity.

The interdependence of relational and material wealth inequality in Pemba, Zanzibar.

The extent of inequality in material wealth across different types of societies is well established. Less clear, however, is how material wealth is associated with relational wealth, and the implications of such associations for material wealth inequality. Theory and evidence suggest that material wealth both guides, and is patterned by, relational wealth. While existing comparative studies typically assume complementarity between different types of wealth, such associations may differ for distinct kinds of relational wealth. Here, we first review the literature to identify how and why different forms of relational wealth may align. We then turn to an analysis of household-level social networks (food sharing, gender-specific friendship and gender-specific co-working networks) and material wealth data from a rural community in Pemba, Zanzibar. We find that (i) the materially wealthy have most relational ties, (ii) the associations between relational and material wealth-as well as relational wealth more generally-are patterned by gender differences, and (iii) different forms of relational wealth have similar structural properties and are closely aligned. More broadly, we show how examining the patterning of distinct types of relational wealth provides insights into how and why inequality in material wealth remains muted in a community undergoing rapid economic change. This article is part of the theme issue 'Evolutionary ecology of inequality'.

Using Relative and Absolute Measures for Socioeconomic Inequalities in Health: Experiences from a Retrospective Cohort Study on COVID-19.

One approach to reducing the burden of diseases can be to identify socioeconomically vulnerable groups. We aimed to estimate the socioeconomic inequality of in-hospital deaths using relative and absolute indices of socioeconomic inequality. In this retrospective cohort study on Covid-19 patients; age, gender, marital status, education level, date of admission, diagnostic method, and final condition were measured. Socioeconomic inequality in inhospital death was assessed using three approaches. We used the relative index of inequality (RII) to measure relative inequality. We used two approaches to evaluate absolute inequality: the slope index of inequality (SII) and the concentration index (ci). Overall, 587 patients' data were collected and 42 (7.2%) of these patients died in the hospital. There were statistically significant differences between the case-fatality rates of different levels of education (P<0.001). In addition, all the inequality indices showed that the distribution of COVID-19-related deaths was higher among the lower education levels. Accordingly, after controlling the effect of age, gender, and comorbidities the RII indicated that the case fatality rate in the lowest education level was 9.42 (95% CI: 2.23 to 39.01, P<0.001) times compared to the case fatality rate in the highest level of education. The results of all three approaches indicate considerable education inequality in CFR in favor of groups of high education levels. These results can improve the prioritization and impact of public health interventions, including prevention and diagnosis of Covid-19 in favor of vulnerable groups.

Model Framework for Consumer Protection and Crypto-Exchanges Regulation

Cross-border insolvency of crypto-exchanges, cyber-risks, transnational character of activities with cryptocurrencies, and financial frauds on the Internet are among the key threats for individuals who use Bitcoin as an investment. Moreover, crypto-exchanges impose consumer agreements containing provisions limiting their liability for hacker attacks and other clauses promoting inequality in relations with investors. All the named obstacles highlight the vulnerability of unsophisticated individuals investing in digital assets and have pointed out the necessity to adopt an internationally recognized model of rules for crypto-exchanges, otherwise, it will be impossible to effectively protect the rights of investors engaged in the activities of intermediaries exchanging and keeping decentralized cryptocurrencies. The purpose of the study is to elaborate on the fundamentals for constructing an international legal framework protecting consumers from risks arising from the activities of crypto-exchanges dealing with decentralized cryptocurrencies. Based on the methodology of comparative legal study, this paper examines the judicial practice of various countries and the legislation of jurisdictions popular among crypto-exchanges. The research explores the nature of Bitcoin, describes the types of crypto-exchanges and discusses the main approaches to crypto-exchanges regulation. It argues that an international framework on crypto-exchanges should be based on understanding Bitcoin as a commodity which is situated in the place of crypto-exchange incorporation, licensing of crypto-exchanges, and self-regulation.

Social inequalities in male cancer in a metropolis in the Southeast region of Brazil.

To analyze inequalities in incidence, mortality, and estimated survival for neoplasms in men according to social vulnerability. Analysis of cases and deaths of all neoplasms and the five most common in men aged 30 years or older in the city of Campinas (SP), between 2010 and 2014, using data from the Population-Based Cancer Registry (RCBP) and the Mortality Information System (SIM). The areas of residence were grouped into five social vulnerability strata (SVS) using São Paulo Social Vulnerability Index. For each SVS, age-standardized incidence and mortality rates were calculated. A five-year survival proxy was calculated by complementing the ratio of the mortality rate to the incidence rate. Inequalities between strata were measured by the ratios between rates, the relative inequality index (RII) and the angular inequality index (AII). RII revealed that the incidence of all neoplasms (0.66, 95%CI 0.62-0.69) and colorectal and lung cancers were lower among the most socially vulnerable, who presented a higher incidence of stomach and oral cavity cancer. Mortality rates for stomach, oral cavity, prostate and all types of cancer were higher in the most vulnerable segments, with no differences in mortality for colorectal and lung cancer. Survival was lower in the most social vulnerable stratum for all types of cancer studied. AII showed excess cases in the least vulnerable and deaths in the most vulnerable. Social inequalities were different depending on the tumor location and the indicator analyzed. There is a trend of reversal of inequalities between incidence-mortality and incidence-survival, and the most social vulnerable segment presents lower survival rates for the types of cancer, pointing to the existence of inequality in access to early diagnosis and effective and timely treatment.

National estimates of occupation-related inequalities in all-cause mortality using linked Census-mortality data

ObjectiveThis report aims to provide national estimates of occupation-related inequalities in all-cause mortality for Australian residents aged 25–64 years. MethodData came from the 2016 Census linked to Deaths Registrations, available via the Multi-Agency Data Integration Project. Using negative binomial regression, we estimated age-adjusted relative and absolute inequalities in all-cause mortality rates in the 13 months following Census according to occupation, defined using the Australian and New Zealand Standard Classification of Occupations (eight major groups), using managers as the reference group. ResultsAmong 10.8M people, there were 20,987 deaths. Age-adjusted mortality rates were lowest among managers and professionals and were generally highest for manual occupations, for example, among men, relative risks (RR) for labourers ranged across age groups from 1.44 (95% CI 1.19–1.75, age 54–64) to 2.99 (1.93–4.65, age 25–34); among women, the RR for machine operators and drivers were 3.95 (1.39–11.21 in age 25–24 and 2.73 (1.66–4.49) in age 45–54, but there was relatively little variation by occupation in women aged 35–44 and 55–64. Around one in five deaths (23% for men, 17% for women) were associated with being in an occupation other than manager. ConclusionThese findings highlight that there is benefit in documenting national mortality inequalities according to occupation in addition to other measures of socioeconomic position. They provide further insights into socioeconomic inequalities in mortality. Implications for public healthMethods that aim to reduce mortality for those in manual occupations, particularly among young men, will reduce inequalities and improve population health.

Bisexual People Experience Worse Health Outcomes in England: Evidence from a Cross-Sectional Survey in Primary Care

ABSTRACT Persistent inequalities in relation to health outcomes continue to exist among patients identifying as lesbian, gay, and bisexual (LGB), and very little is known about outcomes specific to bisexual populations. This study’s aim was to compare the health of individuals identifying as LGB with heterosexual counterparts within primary care in England. Cross-sectional survey data from the year 10 (2015/2016) English General Practice Patient Survey (GPPS) dataset, which consisted of 836,312 responses (38.9% response rate), including 23,834 people who identified as gay, lesbian, bisexual or “other” was analyzed. Health outcomes were assessed through self-reported quality of life, physical and mental health, and confidence in managing own health. Multifactorial logistic regression (adjusting for age, ethnic group, working status, and socioeconomic status) were conducted. Long-term physical and mental health problems were more than twice as likely to be reported for people within LGB groups compared to the heterosexual group for both genders, except bisexual women where the odds were more than four times greater (OR = 4.275, 95% CI, 3.896, 4.691; p < .001). Bisexual women were half as likely to report the absence of a long-term health problem (OR = 0.452, 95% CI 0.419, 0.488; p < .001). LGB groups across both genders, reported a higher proportion of individuals that did not feel confident in managing their health and experienced significantly worse quality of life compared to heterosexuals. LGB patients consistently report poorer health outcomes than heterosexual patients. Bisexual people of both genders consistently experienced worse physical and mental health outcomes compared with the other recorded sexual orientations.

Sociodemographic inequalities in mortality from drowning in the Baltic countries and Finland in 2000–2015: a register-based study

BackgroundDrowning is an important public health problem. Some evidence suggests that the risk of drowning is not distributed evenly across the general population. However, there has been comparatively little research on inequalities in drowning mortality. To address this deficit, this study examined trends and sociodemographic inequalities in mortality from unintentional drowning in the Baltic countries and Finland in 2000–2015.MethodsData for Estonia, Latvia and Lithuania came from longitudinal mortality follow-up studies of population censuses in 2000/2001 and 2011, while corresponding data for Finland were obtained from the longitudinal register-based population data file of Statistics Finland. Deaths from drowning (ICD-10 codes W65–W74) were obtained from national mortality registries. Information was also obtained on socioeconomic status (educational level) and urban-rural residence. Age-standardised mortality rates (ASMRs) per 100 000 person years and mortality rate ratios were calculated for adults aged 30–74 years old. Poisson regression analysis was performed to assess the independent effects of sex, urban-rural residence and education on drowning mortality.ResultsDrowning ASMRs were significantly higher in the Baltic countries than in Finland but declined by nearly 30% in all countries across the study period. There were large inequalities by sex, urban-rural residence and educational level in all countries during 2000–2015. Men, rural residents and low educated individuals had substantially higher drowning ASMRs compared to their counterparts. Absolute and relative inequalities were significantly larger in the Baltic countries than in Finland. Absolute inequalities in drowning mortality declined in all countries across the study period except between urban and rural residents in Finland. Changes in relative inequalities were more variable during 2000–2015.ConclusionDespite a sharp reduction in deaths from drowning in the Baltic countries and Finland in 2000–2015, drowning mortality was still high in these countries at the end of the study period with a substantially larger risk of death seen among men, rural residents and low educated individuals. A concerted effort to prevent drowning mortality among those most at risk may reduce drownings considerably in the general population.

Socioeconomic disparities and concentration of the spread of the COVID-19 pandemic in the province of Quebec, Canada

BackgroundRecent studies suggest that the risk of SARS-CoV-2 infection may be greater in more densely populated areas and in cities with a higher proportion of persons who are poor, immigrant, or essential workers. This study examines spatial inequalities in SARS-CoV-2 exposure in a health region of the province of Quebec in Canada.MethodsThe study was conducted on the 1206 Canadian census dissemination areas in the Capitale-Nationale region of the province of Quebec. The observation period was 21 months (March 2020 to November 2021). The number of cases reported daily in each dissemination area was identified from available administrative databases. The magnitude of inequalities was estimated using Gini and Foster-Greer-Thorbecke (FGT) indices. The association between transmission and socioeconomic deprivation was identified based on the concentration of transmission in socially disadvantaged areas and on nonparametric regressions relating the cumulative incidence rate by area to ecological indicators of spatial disadvantage. Quantification of the association between median family income and degree of exposure of dissemination areas was supplemented by an ordered probit multiple regression model.ResultsSpatial disparities were elevated (Gini = 0.265; 95% CI [0.251, 0.279]). The spread was more limited in the less densely populated areas of the Quebec City agglomeration and outlying municipalities. The mean cumulative incidence in the subsample made up of the areas most exposed to the pandemic was 0.093. The spread of the epidemic was concentrated in the most disadvantaged areas, especially in the densely populated areas. Socioeconomic inequality appeared early and increased with each successive pandemic wave. The models showed that areas with economically disadvantaged populations were three times more likely to be among the areas at highest risk for COVID-19 (RR = 3.55; 95% CI [2.02, 5.08]). In contrast, areas with a higher income population (fifth quintile) were two times less likely to be among the most exposed areas (RR = 0.52; 95% CI [0.32, 0.72]).ConclusionAs with the H1N1 pandemics of 1918 and 2009, the SARS-CoV-2 pandemic revealed social vulnerabilities. Further research is needed to explore the various manifestations of social inequality in relation to the pandemic.

Inequalities of Infant Mortality in Ethiopia.

(1) Background: Infant mortality is viewed as a core health indicator of overall community health. Although globally child survival has improved significantly over the years, Sub-Saharan Africa is still the region with the highest infant mortality in the world. In Ethiopia, infant mortality is still high, albeit substantial progress has been made in the last few decades. However, there is significant inequalities in infant mortalities in Ethiopia. Understanding the main sources of inequalities in infant mortalities would help identify disadvantaged groups, and develop equity-directed policies. Thus, the purpose of the study was to provide a diagnosis of inequalities of infant mortalities in Ethiopia from four dimensions of inequalities (sex, residence type, mother's education, and household wealth). (2) Methods: Data disaggregated by infant mortalities and infant mortality inequality dimensions (sex, residence type, mother's education, and household wealth) from the WHO Health Equity Monitor Database were used. Data were based on Ethiopia's Demographic and Health Surveys (EDHS) of 2000 (n = 14,072), 2005 (n = 14,500), 2011 (n = 17,817), and 2016 (n = 16,650) households. We used the WHO Health Equity Assessment Toolkit (HEAT) software to find estimates of infant mortalities along with inequality measures. (3) Results: Inequalities related to sex, residence type, mother's education, and household wealth still exist; however, differences in infant mortalities arising from residence type, mother's education, and household wealth were narrowing with the exception of sex-related inequality where male infants were markedly at a disadvantage. (4) Conclusions: Although inequalities of infant mortalities related to social groups still exist, there is a substantial sex related infant mortality inequality with disproportional deaths of male infants. Efforts directed at reducing infant mortality in Ethiopia should focus on improving the survival of male infants.