Welfare Inequality Research Articles

A maternal and child health administrative cohort in Scotland: the utility of linked administrative data for understanding early years' outcomes and inequalities

IntroductionThe early years are considered one of the most impactful points in the life course to intervene to improve population health and reduce health inequalities because, for example, both ill health and social disadvantage can track into adulthood. Scotland's outstanding systems for data linkage offer untapped potential to further our understanding of when and why inequalities in child health, development and wellbeing emerge. This understanding is vital for the consideration of policy options for their reduction. MethodsBirth registrations, hospital episodes, dispensed community prescriptions, child health reviews and immunisation records were linked for 198,483 mother-child pairs for babies born in Scotland from October 2009 to the end of March 2013, followed up until April 2018 (average age 6 years). ResultsOutcomes include birthweight and newborn health, dispensed prescriptions for mental health medications, tobacco smoke exposure, infant feeding, immunisations, hospitalisation for unintentional injuries, socio-emotional, cognitive and motor development, and overweight and obesity. Several measures are repeated throughout childhood allowing examination of timing, change and persistence. Socio-economic circumstances (SECs) include neighbourhood deprivation, relationship status of the parents, and occupational status. Descriptive analyses highlight large inequalities across all outcomes. Inequalities are greater when measured by family-level as opposed to area-level, aspects of socio-economic circumstances and for persistent or more severe outcomes. For example, 41.4% of the most disadvantaged children (living with a lone, economically inactive mother in the most deprived fifth of areas) were exposed to tobacco smoke in utero and in infancy/toddlerhood compared to <1% in the least disadvantaged children (living with a married, managerial/professional mother in the least deprived quintile of areas). ConclusionThis novel linkage provides a longitudinal picture of health throughout the early years and how this varies according to family- and area-level measures of SECs. Future linkages could include other family members (e.g. siblings, grandmothers) and other sectors (e.g. education, social care). The creation of additional cohorts would allow for long-term and efficient evaluation of policies as natural experiments.

How Locus of Control Predicts Subjective Well-Being and its Inequality: The Moderating Role of Social Values

AbstractPrevious research has established the central role of an individuals’ locus of control (LoC) in influencing subjective well-being. However, earlier studies have predominantly omitted an exploration of potential moderating factors at the country-level and have rarely delved into the influence of LoC on an important yet often-overlooked dimension of well-being—namely, subjective well-being inequality. Addressing these gaps, this study examines the association between individuals’ LoC and subjective well-being, considering both the mean and inequality aspects. Additionally, it explores the moderating influence of country’s social values, particularly the individualism-collectivism dimension. Utilizing data from the Integrated Values Survey, comprising 170,000 observations across 37 countries from 1996 to 2022, our study confirms a strong positive relationship between LoC and subjective well-being while also unveiling a strong negative relationship with subjective well-being inequality. Moreover, it demonstrates that country’s social values exert significant moderation effects on the relationship between LoC and subjective well-being, affecting both the mean level and inequality aspects, albeit in opposing directions. By employing the Oaxaca-Blinder decomposition, our findings support the importance of structural effects. Understanding how increasing LoC shapes people’s wellbeing in a society holds implications for policymaking and contributes to ongoing discussions on collective choice and inequality.

Impact of the COVID-19 pandemic on intra-household gender disparities in the Middle East and North Africa region: A scoping review protocol.

The Middle East and North Africa (MENA) is a global outlier both for its low female labor force participation and investment in early childhood development services, and consistently ranks lowest on global rankings of gender parity. While the impact of the COVID-19 pandemic on global gender inequity has been acknowledged, specific challenges faced by partnered-women in MENA are underexplored. Additionally, with over half of the region affected by conflict and displacement, exploring these impacts sheds light on understudied gender disparities in humanitarian contexts during the pandemic. This scoping review aims to examine intra-household gender disparities during the COVID-19 pandemic, adding to a more comprehensive understanding of this particular public health emergency's worldwide ramifications. The hypothesis is that the pandemic has exacerbated women's pre-existing constraints in the MENA region, worsening gender inequities in economic empowerment, healthcare access, and general well-being. This review will explore intra-household gender disparities in decision-making, household labor division, economic independence, health, and access to resources and services during the COVID-19 pandemic that have been reported to have been affected by COVID-19 globally. Following PRISMA guidelines for Scoping Reviews, a comprehensive search will be conducted in APA PsycINFO, Arab World Research Source: Al Masdar, EconLit, Global Health, MEDLINE, Scopus, and Web of Science Core Collection, in consultation with an information specialist. Studies in English, French and Arabic from January 2020 to August 2024 will be included. Four independent reviewers will screen studies, and data will be charted, coded, and narratively synthesized. This review is expected to shed light on gender disparities in healthcare accessibility, mobility, and decision-making during the COVID-19 pandemic across low- and middle-income countries in the MENA region, adding to the global literature.

Social inequalities in the mental well-being of adolescents in Barcelona (2016-2021)

Abstract Crises have the potential to affect mental well-being (MWB), especially at vital stages of personal development such as adolescence. The objective of this study was to investigate the 2016-21 trends of social inequalities in the MWB of adolescents in Barcelona, stratifying by sex. Sequential, cross-sectional study based on the FRESC survey, held by the ASPB, representative of 8th and 10th grade adolescents (13-16 years old) schooled in Barcelona, in 2016 (N = 2,154) and 2021 (N = 2,299). MWB was examined using the validated WEMWBS, scoring from 14 (lowest) to 70 (highest) MWB. A temporal trend analysis of inequalities in MWB was carried out using the student socioeconomic status (SES) (low/average/high), measured with the validated FAS. For each group, the effect size of the WEMWBS means was measured with Cohen’s D. Linear regressions were performed, adjusting for academic grade, student country of origin, type of school and school index of vulnerable students. Adjusted β coefficients (aβ) and their statistical significance (p<.05) were estimated. In 2016, boys had higher MWB mean scores than girls (54.0 vs 50.8) (p<.01). In 2021, sex differences persisted, but with lower scores (51.7 vs 47.0) (p<.01) and still with a moderate effect size (0.52 in 2021 vs 0.40 in 2016). In multivariate regression models, boys in low SES showed the greatest MWB decrease in 2016 (low vs high SES: aβ= -3.44; p<.01). A significant temporal trend 2016-2021 of MWB worsening was observed in all groups, except for boys in low SES. The greatest deterioration in MWB was observed in girls, similarly in different SES (low SES: aβ= -3.52; p<.01). Boys in low SES showed the worst MWB in 2016 whereas all SES categories of girls had a significant trend of deterioration in MWB (2016-21). The latter could be attributed, among other factors, to a differential effect of the COVID-19 pandemic. These results underline the importance of addressing inequalities in the MWB, particularly among adolescent girls. Key messages • This study reveals a deterioration in mental well-being temporal trends (2016-2021) among adolescents in Barcelona, especially in girls. • Findings emphasize the need to address social inequalities for improving mental well-being outcomes in adolescent populations.

10.N. Scientific session: Gender and parenthood: short and long-term income, career, and health inequities

Abstract Despite the last decades’ changes in the distribution of household and child-rearing tasks, its main responsibility tends to fall on women. As such, parenting may remain an important determinant of gender inequalities in income, careers, and health and well-being. In 2022, on average, European women’s gross income was 12.7% below men’s. This income gap is, in part, explained by inequalities in full-time employment: in the EU, 31.5% of women with children worked part-time, which contrasts with 20.2% of women without children, with 4.9% of men with children, and 7.2% of men without children. These income and career impacts may occur due to the persistence of some traditional conceptions of the division of paid and nonpaid labor. These conceptions, and the subsequent inequalities in career progression and income, may be reflected in women’s living conditions, work-family conflict, chronic strain, well-being, and health. Yet, it can also be posited that men, experiencing the pressure to remain the main provider in the family and the most recent expectations to comply with childrearing roles, may also see their well-being and health affected. However, countries with higher gender equity have shown better results in life expectancy and healthy life expectancy for women and men. It can be argued that women and men, especially those who have children, benefit from countries with more progressive parental policies, such as longer and more equally divided parental leaves, accessible childcare, or flexible working schemes. It could, thus, be expected that these countries present higher gender equity in paid and nonpaid work division, career progression, and income, with a higher couple balance, and healthier family environments, with health gains for women and men who are parents and their children. This workshop aims to present and open to discussion recent research outcomes on the role of parenthood on income, career, and health inequalities across European countries. It will show results from quantitative and qualitative studies that focus on analyzing these impacts in the short- and long-term. By discussing these results, researchers and public health professionals may grasp parental, labor market, or social policies or health programs to foster gender equality in access to better living conditions and health, especially during and after parenthood. Key messages • Parenthood may widen gender inequities regarding income and career progression, contributing to the gender gap in health and well-being. • By understanding the magnitude of gender inequities and their distribution across countries, public health researchers and professionals may identify policies that effectively address the gender gap.

Comparing the Health Status of Immigrant and New Zealand-Born Older Adults in Aotearoa New Zealand: The Role of Socioeconomic Position.

The study investigated the health status of older migrants relative to their New Zealand-born peers. We adopted a holistic view of health (physical, mental, and social) and a structural approach to health disparities based on migrant status and socioeconomic position. Using case-control matching based on age, gender, and education, the health status of 357 older migrants and 357 New Zealand-born older adults was compared. Older migrants reported significantly poorer social health. Health inequities were patterned by socioeconomic status. Working class older migrants had significantly poorer physical, mental, and social health than their New Zealand-born peers. Inequities in social wellbeing persisted even at the upper end of the social gradient. Migrant background is an important social determinant of health in older age. The reduced social wellbeing of economically advantaged migrants highlights vulnerabilities regardless of socioeconomic position and the need for targeted social policies.

Correction to: Demographic and socio-economic inequalities in subjective wellbeing: analysis of repeated cross-sectional health surveys in England 2010-2019.

Correction to: Demographic and socio-economic inequalities in subjective wellbeing: analysis of repeated cross-sectional health surveys in England 2010-2019.

Demographic change, secular stagnation, and inequality: automation as a blessing?

Abstract We study whether the increased adoption of available automation technologies allows economies to avoid the negative effect of aging on per capita output. We develop a quantitative theory in which firms choose to which extent they automate in response to a declining workforce and rising old-age dependency. An important element in our model is the integration of two capital types: automation capital that acts as a substitute to human labor, and traditional capital that is a complement to labor. Empirically, our model's predictions largely match data regarding automation (robotization) density across OECD countries. Simulating the model, we find that aging-induced automation only partially compensates the negative growth effect of aging in the absence of technical progress in automation technology. One reason is that automated tasks are no perfect substitutes for non-automated tasks. A second reason is that automation raises the interest rate and thus inhibits positive behavioral reactions to aging (later retirement and investment in human capital). Moreover, increased automation generates a falling net labor share of income and rising welfare inequality. We evaluate alternative policy responses to cope with this inequality.

Creating an Integrated System of Data and Statistics on Household Income, Consumption, and Wealth

The nation's disparate federal statistics makes it difficult to accurately measure income and wealth inequality and other aspects of economic well-being for the nation's households and families. This report provides the recommendations from a panel appointed by The Committee on National Statistics (CNSTAT) of the National Academies of Sciences, Engineering, and Medicine. The report reviews the major income, consumption, and wealth statistics currently produced by U.S. statistical agencies, provides guidance for modernizing and integrating the information to better inform policy and research, and builds on the current effort at CNSTAT to create a 21st Century Data Infrastructure to use blended data from multiple sources. In addition to providing guidance on the appropriate definitions of household, family, and individual income, consumption, and wealth, and variations in definitions that would be useful for particular purposes, the report provides suggestions for pathways forward using multiple data sources to construct a data infrastructure for income, consumption and wealth for households. The report highlights new statistics that help in measuring the disparities in income, consumption and wealth and the changes over time in both levels and inequalities, always stressing that the disparities occur both across socio-demographic characteristics and geography. The report highlights the potential for blending multiple data sources and modeling across data sources, including surveys, tax records, state and federal administrative records, and commercial data, and documents the legal and administrative barriers to creating integrated, high-quality estimates and a data infrastructure for researchers to evaluate the impacts of public policy.

Demographic and socio-economic inequalities in subjective wellbeing: analysis of repeated cross-sectional health surveys in England 2010-2019.

Good subjective wellbeing (SWB) is a key societal aspiration. The study of SWB determinants is of increasing interest. The present study aimed to examine national inequalities in SWB, and trends in these inequalities, for England across five demographic (sex and age) and socio-economic (educational level, household income and living alone) characteristics. The relative index of inequalities (RII) and slope index of inequalities (SII) were calculated from repeated cross-sectional data from the Health Survey for England from 2010 to 2019 (excluding 2017 and 2018 as our outcome variable was not collected in these years), in a total of 90 236 participants aged 16+. SWB was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), treated as a dichotomous variable with high and low levels of SWB>40 and≤40, respectively. There were significant inequalities in SWB by income (RII from 1.086 to 1.116), educational level (RII from 0.893 to 0.941) and between people living alone or not (RII from 0.908 to 0.937). The RII and SII trends were not statistically significant. Higher socio-economic status could play a protective role for SWB, and people in the most deprived socio-economic positions may be at higher risk for low SWB. These associations have remained stable over time.

Analysis of Village Fund Management in Efforts to Improve Community Welfare in Setuta Janapria Village, Central Lombok 2020-2022

The allocation of village budget in Setuta Village has not been evenly distributed in each region. Unequal management of village funds causes inequality in development and community welfare. The primary objective of this study was to analyse the impact of village fund management on improving community welfare in Setuta Village, Janapria Sub-district, Central Lombok Regency. This descriptive quantitative research uses primary data collected from 44 households as samples. The results showed that the management of village funds in Setuta Village was not fully in accordance with applicable regulations. The impact of village fund management on community welfare is in the medium category. The positive impact of village fund management can be seen in the education sector, health, health services, and settlement facilities such as the provision of clean water sources for the community. However, the management of village finances has not yet had a significant impact on increasing income, expenses, living conditions, and transportation facilities.

The impact of financial inclusion on rural–urban households welfare inequality in Ghana: A decomposition analysis

AbstractThis article examined the impact of financial inclusion on rural–urban households' welfare inequality in Ghana using nationally representative survey data sourced from the seventh round of the Ghana Living Standard Survey. The article used a multidimensional financial exclusion index and the real per adult equivalent measures of total annual household consumption expenditure as measures of financial inclusion and welfare, respectively. The article employed the instrumental variable estimation technique to account for the issues of endogeneity and sample selectivity bias associated with measuring financial inclusion. The estimated results from recentered influenced function‐Ordinary Least Squares of the unconditional quantile regression and the Oaxaca‐Blinder techniques show significant rural–urban welfare gaps in favor of urban households at the mean and across the selected quantiles. The study also found that differences in financial inclusion between rural and urban households contribute significantly to the welfare gaps, while the economic returns to financial inclusion reduce the welfare gaps both at the mean and the selected quantiles. The study recommends that policies aimed at improving financial inclusion as well as strengthening financial institutions in rural areas be put in place to help reduce the rural–urban welfare inequality in Ghana.

China’s ongoing rural to urban transformation benefits the population but is not evenly spread

China prioritizes a coordinated and sustainable shift from rural to urban areas, termed rural-urban transformation. This involves land, population, and industry urbanization. Here we explore the spatiotemporal dynamics of rural-urban transformation patterns in China, focusing on the degree of integrated transformation and the coupling between the three tracks. To conduct our investigation, we utilized the urbanization cube theory, satellite-derived gridded datasets, and the self-organizing map. Our findings show that eastern China has higher levels of integrated transformation and coupling compared to western China. There has been an overall increase in the coupling of China’s three rural-urban transformation tracks. We identified six typical rural-urban transformation patterns across China. Over time, 53.58% of prefectures improved in rural-urban transformation patterns, 3.44% degraded, and 42.98% (mainly in western China) remained unchanged. More importantly, we highlight that the increasing and coupling rural-urban transformation in China has reduced inequities in urban and rural well-being.

Welfare comparisons within countries beyond GDP: An application to Nigeria

This study implements a novel method to assess subnational welfare differences, addressing the limitations of traditional measures based solely on output or consumption, and ordinal measures such as HDI. We develop a unified and theoretically grounded welfare measure that incorporates consumption, leisure, inequality in consumption and leisure, and life expectancy. The resulting welfare measure is cardinal and interpretable as a consumption equivalent, offering an advantage over ordinal indices such as HDI. Applying this method to Nigeria, the analysis reveals that welfare is positively correlated with consumption and HDI because all incorporate aspects of consumption, inequality, and health. However, welfare differences are four times greater than those suggested by consumption alone, with significantly different rankings, underscoring the critical roles of health and inequality in welfare. Additionally, the innovative inclusion of leisure, measured as non-labor time, significantly changes welfare rankings compared to HDI or IHDI.

Analysis of the Influence of Education and Regional Minimum Wage Value on Employment Opportunities and Economic Growth of the District/City of Bali Province 2011-2022

Low levels of education and minimum wages make job opportunities even lower, thus having an impact on economic growth. Various efforts are designed and implemented by the regional government which are solely used to increase growth for the region itself and are then expected to have a positive impact on the welfare of the community, however, there is still inequality in community welfare between districts/cities in Bali Province. The objectives of this research are 1) to analyze the influence of education level and minimum wage on employment opportunities in Bali Province, 2) to analyze the influence of education level, minimum wage and employment opportunities on economic growth in Bali Province, 3) To analyze how the influence of employment opportunities mediates education level and minimum wage on economic growth in Bali Province. The analysis techniques used in this research are descriptive analysis and path analysis. The data used is panel data consisting of a combination of time series and cross section data with 120 observations obtained through secondary data. The results of this research show that 1) the level of education has a positive and significant effect on job opportunities in Bali Province, 2) the minimum wage has a positive and significant effect on job opportunities in Bali Province, 3) the level of education has a positive and significant effect on economic growth in the Province Bali, 4) the minimum wage has a positive and significant effect on the economic growth of Bali Province, 5) employment opportunities as an intervening variable or mediate the level of education and the minimum wage on employment opportunities in the Province of Bali.

Use of natural environments is associated with reduced inequalities in child mental wellbeing: A cross-sectional analysis using global positioning system (GPS) data

Exposure to natural environments may benefit child mental wellbeing whilst offering a lever to reduce health inequalities. However, understanding of these relationships is limited by evidence from indirect measures of exposure. We objectively measured children’s direct use of natural environments—and use in low or high physical activity (PA) states—and associated this with their mental wellbeing. We then examined moderation by sex and household income.Using global positioning system and accelerometry data from children (n = 640), we measured mean daily time in natural environments (‘total use’), which we stratified by PA level as ‘passive use’ (sedentary and light PA) and ‘active use’ (moderate and vigorous PA). Logistic regression associated exposures with dichotomised Strengths and Difficulties Questionnaire outcomes (internalising difficulties; externalising difficulties; prosocial behaviour), with interactions to examine moderation.A 10-minute increase in total use was associated with 10.5 % lower risk of abnormal internalising outcomes (OR: 0.895; 95 % CI 0.809, 0.990), and 13.2 % lower risk of abnormal externalising outcomes (OR: 0.868; 95 % CI 0.776, 0.990). This suggests that ∼ 60 min of daily total use was associated with 50 % lower risk of abnormal internalising and externalising outcomes. The relative effects of passive and active use were equal, but their associations were moderated by income independently for specific outcomes. For externalising outcomes, the risk of abnormal scores in lower-income children reduced as passive use increased (P = 0.027) but remained constant for higher-income children. For prosocial outcomes, the likelihood of normal scores increased with active use in lower-income children, but not higher-income children (P = 0.005). Sex did not moderate these associations.The findings suggest that targeted interventions supporting disadvantaged children to use natural environments could help address inequalities in mental wellbeing. Further, the moderated associations with types of use suggest the equigenic effects of natural environments may operate through multiple pathways.

A Macro Study of the Unequal Effects of Climate Change

This paper develops a macro heterogeneous-agent model to quantify the distributional impacts of higher temperatures in the US. Households adapt to temperature by using energy and equipment for heating and cooling. A key insight is that temperature acts as a transfer from nature, augmenting household income by the value of heating or cooling provided by nature. The welfare effects of climate change vary substantially with income, increasing welfare inequality in the colder parts of the US. This heterogeneity results from the effects of climate change on transfers from nature and on households’ extensive-margin decisions to purchase heaters and air conditioners.

Adult Safeguarding Inequalities in Northern Ireland: An Exploratory Study

Abstract Whilst studies of child welfare inequalities have identified the impact of socio-economic deprivation on child protection rates, little is known about how this relates to intervention with adults who have care and support needs. This article examines the impact of area-level deprivation on adult safeguarding (AS) rates in Northern Ireland (NI). Routinely gathered statistics for community AS referrals (2015–2017) were linked to area-level deprivation across NI using service users’ postcode. The relationship between deprivation and the screening, investigation and safeguarding planning stages of intervention was examined. Our analysis identified a clear social gradient in relation to AS referrals; the higher the level of deprivation, the higher the rates of AS screening and protection plans. Findings for investigations showed more variability. Further research is needed to explore the factors associated with areas of high deprivation that shape AS social work responses. To our knowledge, this is the first time AS rates have been explored in relation to deprivation. The study findings, that structural factors play a significant role in AS interventions, will help to determine how and where social work interventions are best focused, helping to shape policy and AS theory.

The Nexus of Regional Integration and Household Welfare: A Case Study of the Yangtze Delta Area

Public policies of regional integration have been widely implemented recently in multiple countries as a significant approach to improving regional economic cooperation and reducing economic inequalities. In China, improving household welfare and narrowing welfare gaps become another major purpose of regional integration. Nevertheless, little attention has been paid to household-level impacts of regional integration on improving welfare. This study provides empirical analysis on impacts of regional integration on household welfare by using the case of the Yangtze Delta area from 2010 to 2020. We find that overall impacts of regional integration on improving household welfare and reducing household welfare inequality are significantly positive, and such impacts reveal spatial heterogeneity. Public transport infrastructural integration and city-level migration are two major mechanisms through which such impacts can be amplified. Results remain feasible after a series of robustness tests. We believe that integration should be further implemented to eliminate poverty and boost social welfare in both developed and developing regions in China, and cross-city and interprovincial trade needs to be promoted as an important means of regional integration.

Correction to: The Painful and Chilling Effects of Legal Violence: Immigration Enforcement and Racialized Legal Status Inequities in Worker Well-Being

Correction to: The Painful and Chilling Effects of Legal Violence: Immigration Enforcement and Racialized Legal Status Inequities in Worker Well-Being