Persistent Inequalities Research Articles

Global Perspectives on Education: A Cross-Cultural Comparisons in the Philippines and Cambodia

Education is a central pillar for economic growth and societal development in any country. Many developing nations such as the Philippines and Cambodia face extensive barriers in establishing high-quality, equitable education structures to meet the needs of all citizens. The objective of this case study is to offer the examination of education systems in the Philippines and Cambodia and analyzes persistent inequities in access, variable quality and lack of inclusion, especially for remote, poor and minority groups. As methodology, the related information and documents will be collected and reviewed to draw the main constraints, challenges and socio-economic disparities in accessing to the education. Results showed that strategies like decentralized governance, multilingual instruction and community school models that catalyze localized innovation are highlighted as means to enhance access and belonging within wider quality assurance frameworks. The core recommendation promotes integrated community-driven education enabling contextual decision-making on key functions while still meeting national benchmarks. This balances flexibility and consistency. Progressive decentralization stages include localized piloting, legal expansions of school authority, budget direct allocations, integrating informal programs, phased function transfers based on assessments, ongoing monitoring and evaluations driving improvements. Key insights spotlight how innovation and cooperation aid localization that respects diversity while quality depends on appropriate standardization and supports. Based on the comprehensive analysis of the challenges and opportunities within the education systems of the Philippines and Cambodia, a set of strategic recommendations is needed to propose to advance towards more inclusive and community-driven models of education. This approach empowers communities to take ownership over key functions based on contextual needs while upholding minimum quality standards. It balances localization and flexibility with wider systemic consistency.

“I would be so proud of you guys and myself:” Exploring guided play learning interactions among Black caregivers and their children within a Black history home learning intervention during the COVID-19 pandemic

Existing literature on Black caregiver’s interactions with their children has overwhelmingly focused on parenting deficits and interventions designed to “fix” Black families. In utilizing the BlackCreate framework (2023), this study explores how Black caregivers intentionally crafted learning spaces for their children within the context of a six month intervention. Brilliant Joy in a Box was a six-month intervention developed in partnership with a Black woman entrepreneur that delivered caregiver-child Black history home learning boxes to families during the COVID-19 pandemic with the goal of addressing the impacts of persistent historical educational inequities for Black youth, the disproportionate impact of the pandemic Black families, and requests from community members seeking additional programming during the winter months. In the current study, we analyzed videos of 77 families interacting during a guided play activity. We found that the learning spaces created by Black families focused on four subject matters and their domains: literacy, scientific curiosity, math, and identity. We also found that Black caregivers organically utilized guided play to promote joyful interaction and learning. Findings underscore the importance of educators and school staff learning from families in order to reimagine learning and design community based interventions.

The future of AVS, dizziness, and vertigo in emergency departments Part iii: A tyranny of distance – the persistence of rural health inequity

The future of AVS, dizziness, and vertigo in emergency departments Part iii: A tyranny of distance – the persistence of rural health inequity In the third article of this five-part series, Dr Millie Nakatsuka discusses the impact of isolation on health equity and the medical decision-making for emergency presentations of acute vestibular syndrome (AVS). People in rural and remote areas bear a significantly higher burden of disease and have poorer health outcomes. They have greater socio-economic disadvantage with lower levels of educational attainment, lower rates of employment, lower income and exhibit more health risk factors with markedly increased rates of obesity, tobacco smoking and alcohol consumption.

Persistent inequality: contemporary inequality in a historical context

Abstract My goal in this commentary is to complement the findings in the article on Education Inequalities by Christine Farquharson, Sandra McNally and Imran Tahir with some general remarks which will provide a context and framework for understanding educational inequalities in Britain. I make five main points, summarized at the start of each section of the commentary.

Temporal dynamics of socioeconomic inequalities in depressive and anxiety symptoms during the COVID-19 pandemic: a scoping review.

The existence of socioeconomic inequalities in the prevalence of symptoms of depression and anxiety is widely acknowledged, and individuals from lower socioeconomic backgrounds tend to exhibit higher rates of symptoms. However, the direction in which the COVID-19 pandemic has influenced these disparities remains uncertain. We therefore aimed to systematically outline the available evidence on the temporal dynamics of socioeconomic inequalities in symptoms related to depression and anxiety during the COVID-19 pandemic across high-income countries. A scoping review was conducted by searching the databases Embase, Scopus and PsycINFO. According to pre-defined eligibility criteria, two reviewers independently screened titles and abstracts as well as full texts of the compiled records. Data from the included studies were extracted using a standardised data-extraction form and analysed numerically and narratively. The scoping review followed the PRISMA-ScR guidelines. A total of 49 studies comprising 149 analyses of socioeconomic indicators in relation to symptoms of depression and anxiety were included. Despite heterogeneous study designs and results, there was a tendency of increasing (40.9%; n = 61) or persistent (38.2%; n = 57) inequality trends to the detriment of those in socially more disadvantaged positions. Increasing inequalities were most pronounced when income was used as a socioeconomic indicator. Groups with lower socioeconomic status appeared most vulnerable in the initial phase of the COVID-19 pandemic. Throughout the pandemic, dynamics were diverse, with persistent trends most frequently reported. Overall, to the detriment of those with lower socioeconomic status, mental-health inequalities persisted or increased in most analyses. Continually monitoring socioeconomic inequalities over time is crucial, since this makes it possible to adapt prevention and intervention strategies to specific pandemic phases. Interventions targeting job security, income security and educational attainment could reduce mental-health inequalities. The results can contribute to preparedness plans for future pandemics and crises.

Assessment of the Association between Socioeconomic Factors and Dental Health Disparities Over a Decade

ABSTRACT Background: Socioeconomic variables continue to play a major role in the global persistence of dental health inequities. The purpose of this study is to evaluate the relationship between socioeconomic characteristics and dental health outcomes at a tertiary-care facility over a 10-year period. Methods: Patient demographics, socioeconomic factors, and dental health outcomes were analyzed retrospectively from dental health records. To determine the relationships between socioeconomic characteristics and disparities in oral health, statistical studies were carried out. Results: Tooth cavities and untreated dental problems were more common in people with lower incomes and educational levels. There were notable differences in oral health outcomes between various socioeconomic groups. Conclusion: In conclusion, this research shows that there is a persistent relationship at a tertiary-care facility between socioeconomic characteristics and disparities in oral health. Reducing disparities in dental health outcomes and advancing oral health equity require addressing socioeconomic causes.

United States Federal Policies Contributing to Health and Health Care Inequities in Puerto Rico.

Puerto Rico, a territory of the United States since 1898, has recently experienced an increasing frequency and intensity of natural disasters and public health emergencies. In 2022, Hurricane Fiona became the latest storm to attract media attention and cast a light on Puerto Rico's deteriorating conditions, including infrastructural failings, health care provider shortages, and high levels of chronic illness. Although recent events have been uniquely devastating, decades of inequitable US federal policy practices have fueled the persistence of health inequities in the territory. Here we demonstrate how existing health and health care inequities in Puerto Rico have been exacerbated by compounding disasters but are rooted in the differential treatment of the territory under US federal policies. Specifically, we focus on the unequal US Federal Emergency Management Agency response to disasters in the territory, the lack of parity in federal Medicaid funding for Puerto Rico, and Puerto Rico's limited political power as a territory of the United States. We also provide empirically supported policy recommendations aimed at reducing health and health care inequities in the often-forgotten US territory of Puerto Rico. (Am J Public Health. 2024;114(S6):S478-S484. https://doi.org/10.2105/AJPH.2024.307585) [Formula: see text].

Gender inequalities: Understanding gender identity and changing trends

The relevance of the subject under consideration is due to the presence of a wide range of issues that are rarely interrelated, as well as the blurring of the concepts of personal and gender identity. This study examines gender identity and its implica-tions for gender inequalities. The purpose of this study is to explore the concept of gender identity and its modern trends of change, with a focus on how they relate to gender inequalities and sustainable development in the context of Kazakhstan. The tasks involve identifying and considering issues related to gender identity, de-veloping an original approach to understanding personal identity, tracking and an-alysing how concepts and views on gender identity are currently changing, and evaluating the ideas of young men and women about issues of gender identity. It was revealed that for a long time the identity of the individual was studied thanks to three conceptual approaches; current trends indicate that identity is changeable, not permanent; two-thirds of the men surveyed hold patriarchal beliefs regarding the family sphere; all the interviewed girls have egalitarian beliefs regarding the role of women in the development of society, career growth, leadership, leadership and much more. The results obtained shed light on the persistence of gender stere-otypes and inequalities in Kazakh society, which have implications for sustainable development.

Reflections on Psychological Critical Race Theory (PCRT) as a framework for disrupting racism in pursuit of social justice

AbstractPsychological Critical Race Theory (PCRT) was introduced in 1998. PCRT illustrates the integral connection of psychological research and theory to the legal framework of Critical Race Theory (CRT). Five tenets of PCRT were described: (1) Spontaneous and persistent influence of race; (2) Fairness is derived from divergent racial experiences; (3) Asymmetrical consequences of racial policies; (4) Paradoxes of racial diversity; and (5) Racial identity requires a multidimensional approach. These tenets are reviewed and updated. A new set of seven PCRT principles are proposed that provide a broad framework within which to examine the PCRT concept and its role in reframing critical approaches to racial justice. Principle 1: Race and culture make each other up; Principle 2: Meaning Matters; Principle 3: Multilevel analysis is critical to unraveling Systemic Racism; Principle 4: Activism is a lever for social change; Principle 5: Power drives racial inequality; Principle 6: Storytelling disrupts status quo narratives; Principle 7: Diversity does not ameliorate systemic racism. PCRT is a 100‐year enterprise of psychological science, offering a complex and comprehensive framework for understanding and ameliorating persistent racial inequality. The comprehensive network of ideas, methods, goals, and strategies can engage and guide this work for years to come.

Are community oncology practices with or without clinical research programs different? A comparison of patient and practice characteristics.

Expanding access to clinical trials in community settings is a potential approach to addressing disparities in accrual of historically underrepresented populations. However, little is known about the characteristics of practices that do not participate in research. We investigated differences in patient and practice characteristics of US community oncology practices with high vs low engagement in clinical research. We included patients from a real-world, nationwide electronic health record-derived, de-identified database who received active treatment for cancer at community oncology practices between November 1, 2017, and October 31, 2022. We assessed patient and practice characteristics and their associations with high vs low research engagement using descriptive analyses and logistic regression models. Of the 178 practices, 70 (39.3%) events had high research engagement, treated 57.8% of the overall 568 540 patient cohort, and enrolled 3.25% of their patients on cancer treatment trials during the 5-year observation period (vs 0.27% enrollment among low engagement practices). Practices with low vs high research engagement treated higher proportions of the following patient groups: ages 75 years and older (24.2% vs 21.8%), non-Latinx Black (12.6% vs 10.3%) or Latinx (11.6% vs 6.1%), were within the lowest socioeconomic status quintile (21.9% vs16.5%), and were uninsured or had no documented insurance (22.2% vs 13.6%). Patient groups historically underrepresented in oncology clinical trials are more likely to be treated at community practices with limited or no access to trials. These results suggest that investments to expand the clinical research footprint among practices with low research engagement could help address persistent inequities in trial representation.

Political Parties: Builders and Destroyers of Ghana’s Drive to Democratic Consolidation

Despite a very checkered political history, Ghana’s Fourth Republic has so far performed relatively better, surviving through eight election cycles. Though political parties are objects of massive supports in Ghana’s drive to democratic consolidation, nevertheless, questions have been raised about the ways in which parties operate in practice. Through the use of concurrent mixed methods design, the study examined the view that Ghanaian political parties are not agents of democracy due to some irresponsible and self-interested actions they usually pursue. The study found that Ghana has made significant progress towards democratic consolidation partly because political parties actively perform the functions of voter mobilization and forming the government. However, despite the strong support for multiparty democracy from Ghanaians, their hopes and expectations have proved illusionary due to persistent poverty and socio-economic inequalities. This has the potential to disempower the poor majority and make democracy the property of few wealthy politicians. Additionally, policy discontinuity and the activities of political vigilantism championed by political parties were identified as notable threats to Ghana’s democratic gains. The study recommended that both the intrinsic and instrumentalist approaches to politics are critical for democratic consolidation and maturity in Ghana.

INTEGRASI TEORI STIGMA ERVING GOFFMAN TERHADAP KEADILAN SOSIAL BAGI “GOOD LOOKING” DAN DISKRIMINASI UNTUK “BAD LOOKING”

This study explores the phenomenon of "lookism" or appearance-based discrimination, which divides individuals into two primary groups: those regarded as attractive or "good looking" and those viewed as less attractive or "bad looking." It reveals that individuals perceived to meet the standards of being good-looking gain social and economic advantages through the "halo effect," wherein their appearance positively influences assessments of their professional and moral capabilities. In contrast, those perceived as less attractive or bad-looking encounter substantial disadvantages, including discrimination in job recruitment and promotion, as well as in social and institutional interactions. Utilizing a literature review with a qualitative research approach and an analytical framework based on Erving Goffman's Stigma Theory, this research demonstrates that physical appearance acts as a discrediting stigma, significantly impacting individuals' social identity and opportunities. The analysis emphasizes the integration of stigma into institutional structures and social practices, resulting in hidden yet systematic discrimination. Furthermore, the study explicates how the media and entertainment industries, through their portrayal of unrealistic beauty standards, reinforce societal beauty stereotypes. This influence on public perceptions heightens social pressure to conform to narrow beauty standards. From a sociological perspective, the unequal distribution of "beauty capital" creates persistent inequalities that affect not only economic opportunities but also political representation and power. This research underscores the need for social interventions and policies that reduce stigma and broaden the definition of beauty, which are crucial for dismantling power structures that perpetuate appearance-based discrimination and for fostering a more inclusive and equitable society. Through an informed and data-driven approach, this study provides essential insights into how social norms and values can be reformed to minimize "lookism" bias and enhance appreciation for human character diversity and complexity.

Labour control through risk and profit-sharing: Social inequalities and exploitation through artisanal and small-scale mining in Ghana

Despite the expanse of studies on artisanal and small-scale mining (ASM) in Africa, discussions on how the organization of workers and the division of work tasks influence labour outcomes in the sector remain marginal. There are growing concerns that ASM may account for rising income inequalities in communities. Using a case study from Ghana and relying on qualitative data from semi-structured interviews with miners and other stakeholders, this paper examines processes of labour exploitation and domination in ASM. It is revealed that ASM labour processes facilitate capitalist accumulation among elites as the organization of work in the sector is moulded around pre-existing social identities and relations. The production of social differences, such as class and gender, is integral to labour exploitation, value extraction and profit accumulation in ASM. The deeply entrenched patriarchal system influences mining practices and facilitates the domination of women in ASM, producing inequalities between men and women. It is argued that capital-labour social relations underpin extractive activities in the sector hence the need to recognize ASM as a capitalist form of production. The paper concludes that the development potential of ASM will not be realized without addressing the persistent gender inequities and prevalence of exploitative relationships in the sector.

Negotiating distinctiveness and building resilience: Arab and Jewish women's acts of micro‐emancipation in the context of Israeli municipal councils

AbstractThe paper narrows the research gaps on women's performances enacted to ascertain their voice and influence in perplexing environments and how these attempts evolve in the particular social, political fields of local government. It shows how women use negotiation to build resilience, cope with persistent gender inequalities and exert influence in strategic management forums of local governments. The findings are based on content analysis of semistructured interviews with 20 Arab and Jewish women members of municipal councils. Three main themes emerged from the analysis of the interview data: “noisy silences”—subtle counter‐moves, disrupting the field and planting new trees and the mysteries of success. These themes encapsulate marks of micro‐emancipation, illustrating women council members' acts of resistance—transforming the imperfections attributed to them by their male counterparts, into opportunities—, allowing to sound their voices and exert influence at the unhospitable and chilly political field of local governments. Women are capable of adapting their negotiation repertoire to the emerging circumstances. The task of changing the playing field of municipal councils is markedly more arduous for women in Arab towns, nonetheless some of them engage it.

A novel approach to patient portal activation data to power equity improvements.

There are significant disparities in access and utilization of patient portals by age, language, race, and ethnicity. We developed ambulatory and inpatient portal activation equity dashboards to understand disparities in initial portal activation, identify targets for improvement, and enable monitoring of interventions over time. We selected key metrics focused on episodes of care and filters to enable high-level overviews and granular data selection to meet the needs of health system leaders and individual clinical units. In addition to highlighting disparities by age, preferred language, race and ethnicity, and insurance payor, the dashboards enabled development and monitoring of interventions to improve portal activation and equity. Data visualization tools that provide easily accessible, timely, and customizable data can enable a variety of stakeholders to understand and address healthcare disparities, such as patient portal activation. Further institutional efforts are needed to address the persistent inequities highlighted by these dashboards.

Is there room for interculturality? Indigenous youth in Peruvian private universities and the scholarship programme Beca 18

ABSTRACT Applying an ethnographic approach, this study examines recently implemented scholarship programmes for Indigenous people in private higher education (HE) institutions in Peru. Interviews with students and staff, participant observations, and participatory activities reveal distrust of scholarship holders by government staff and programme regulators, who exercise various surveillance and control mechanisms. Staff at private universities hinder cultural diversity among students through segregation or integration strategies to deal with Indigenous students, thereby curtailing an intercultural approach. Indigenous students ask for more integration activities and intercultural dialogues as they claim a lack of adequate support programmes and real inclusion, which leads to higher dropout rates. This study contributes to the recovery of students’ voices and concerns by unveiling persistent inequalities in HE. The findings have implications on policy design that take for granted problematic assumptions riddled with colonial prejudices and privatisation ideologies within the field of HE.

Neurodivergence and the Persistence of Neurotypical Norms and Inequalities in Educational and Occupational Settings

Neurodivergence and the Persistence of Neurotypical Norms and Inequalities in Educational and Occupational Settings

The Persistence of Gender Inequality in e-Science: The Case of eSec

The Persistence of Gender Inequality in e-Science: The Case of eSec

ADVANCING GENDER EQUALITY THROUGH GENDER BUDGETING AND AUDITING: A FRAMEWORK FOR GENDER-NEUTRAL BUDGETARY ALLOCATIONS IN INDIA

The present research looks at the importance of gender audits and budgeting as essential instruments for advancing gender equality in India's financial system. This study examines the possibility of gender-neutral budget allocations as a means of addressing the persistent gender-based inequality in Indian society. It explores the history, application, difficulties, and effects of gender budgeting and auditing on the creation of policies and the distribution of resources. This paper presents an efficient framework for gender-neutral budgetary allocations targeted at promoting gender equality in India through an analysis of successful case studies and methods.

Disparities in perinatal COVID-19 infection and vaccination

The COVID-19 pandemic exposed and exacerbated persistent health inequities in perinatal populations, resulting in disparities of maternal and fetal complications. In this narrative review, we present an adapted conceptual framework of perinatal social determinants of health in the setting of the COVID-19 pandemic and use this framework to contextualize the literature regarding disparities in COVID-19 vaccination and infection. We synthesize how elements of the structural context, individual socioeconomic position, and concrete intermediary determinants influence each other and perinatal COVID-19 vaccination and infection, arguing that systemic inequities at each level contribute to observed disparities in perinatal health outcomes. From there, we identify gaps in the literature, propose mechanisms for observed disparities, and conclude with a discussion of strategies to mitigate them.