Relative Social Inequality Research Articles

Early family socioeconomic status and asthma-related outcomes in school-aged children: Results from seven birth cohort studies

ObjectiveTo examine the associations between maternal education and household income during early childhood with asthma-related outcomes in children aged 9–12 years in the UK, the Netherlands, Sweden, Australia, the USA...

Impairments and related social inequalities among adults: a population-based study in São Paulo city, Brazil.

The study of the association of social variables with the prevalence of impairments can provide subsidies for more adequate care and health policies for the most needy people by incorporating social aspects. This article aims to estimate the prevalence of diverse types of impairments, the degree of difficulty, limitations, and the need for help they cause and attest whether this prevalence differ by educational attainment in individuals aged 20 years or older. This is a populational cross-sectional study (2015 Health Survey of São Paulo-ISA Capital). Data from 3184 individuals were analyzed via educational attainment as exposure variable and outcome variables related to visual, hearing, intellectual, and mobility impairments. 19.9% of participants had visual, 7.8%, hearing, 2.7%, intellectual, and 7.4%, mobility impairments. Mobility and intellectual impairments limited participants' daily activities the most, 70.3% and 63.3%, respectively; who, thus, needed the most help: 48.9% and 48.5%, respectively. Lower schooling was associated with a higher prevalence of impairments, greater need for help due to visual and intellectual impairments, and greater limitations due to hearing and visual impairments.

Trends in social inequality in breastfeeding duration in Denmark 2002-2019.

The aim of the present study was to analyse trends in full breastfeeding for at least 4 months across socioeconomic position in Denmark over a 17-year-long period from 2002 to 2019 using parental education as the indicator of socioeconomic position. The study used data on full breastfeeding collected between 2002 and 2019 by community health nurses in the collaboration Child Health Database, n=143,075. Data were linked with five categories of parental education from population registers. Social inequality was calculated as both the relative (odds ratio) and absolute social inequality (slope index of inequality). A trend test was conducted to assess changes in social inequality over time. A social gradient in full breastfeeding was found for the entire study period. The odds ratio for not being fully breastfed for at least 4 months ranged from 3.30 (95% confidence interval 2.83-3.84) to 5.09 (95% confidence interval 4.28-6.06) during the study period for infants of parents with the lowest level of education (primary school) compared with infants of parents with the highest level of education (5+ years of university education). The slope index of inequality was between -38.86 and -48.81 during the entire study period, P=0.80. This indicated that both the relative and absolute social inequality in full breastfeeding to at least 4 months of age was unchanged in the study period from 2002 to 2019. This study showed a persistent relative and absolute social inequality in full breastfeeding for at least 4 months from 2002 to 2019 in Denmark.

Green patents: instruments against climate change and related social inequalities

Green patents: instruments against climate change and related social inequalities

Challenges and Future Directions for Promoting Intersectional Quantitative Studies in Physical Activity Research.

Understanding health inequalities is essential for improving social justice. Intersectionality refers to a theoretical framework for studying the intersection of multiple social categorizations that create unique experiences and related social inequalities. Currently, the majority of the intersectional studies in the physical activity field have a qualitative design; thus, there is a need for quantitative intersectional studies. This commentary aims to explore primary obstacles impeding intersectional quantitative research and provide recommendations for overcoming these obstacles in physical activity research. In the commentary, we discuss that the lack of accessibility of large-scale and diverse data sets, and suboptimal social categorizations and intersectionality-related questions may contribute to the scarcity of intersectional quantitative research in the field. To facilitate intersectional quantitative analyses, we advocate for making large-scale data sets accessible for intersectional secondary analyses, diverse sampling, standardizing questions and categories related to intersectionality, promoting inclusive research designs and methods, and using the appropriate questions and social categorization that reflect the distinct experiences of each subgroup. By addressing these challenges, researchers may gain new insights into health disparities, making physical activity research more inclusive and contributing to more equitable health outcomes.

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.

Parental mediation of adolescents’ technology use: Unequal parenting practices

This study explores parental mediation – its patterns, purpose and intention, the intentions behind it, and related social inequalities – from the perspective of the ideal of intensive parenting. Parental mediation in the form of restricting or monitoring teenagers’ technology use might mitigate the harm of the intensive or risky online behaviour. Moreover, active mediation strategies might improve the teenagers’ digital literacy by obtaining specific skills that foster appropriate online behaviour. Therefore, the paper argues that parental mediation has become a highly relevant aspect of contemporary parenting practices. The paper is based on thematic analyses of semi-structured interviews on children’s screen time and parental mediation strategies. The interviews were carried out with 29 parents of adolescents in Hungary in 2019. The findings show that restriction and active mediation primarily aimed at protecting children from risks, as a resource-intensive practice, form part of the contemporary parenting skill set. This study contributes to understanding how these skills constitute a digital cultural capital, and thereby how parenting can enhance the digital inequality.

Opportunity and inequality in the emerging esports labor market

Esports is often described as a growing industry ripe with financial opportunities for young professional, competitive gamers. However, these claims rarely consider how income is distributed amongst players. This study uses prize earnings data from 2005 to 2019 to examine labor market inequality and related social inequalities and social stratifications. Lorenz curves and Gini coefficients show that inequality has increased in the labor market overall and the labor markets for the five top games based on total prizes awarded ( Dota 2, Counter-Strike: Global Offensive, Fortnite, League of Legends, StarCraft II). Competitors can expect to earn more today than in 2005, but median incomes have shown sporadic and inconsistent growth compared with top incomes. Moreover, most competitors earn less than the US poverty threshold. Comparing the earnings of the top female players to the whole labor market shows that gender inequalities exist in median incomes and the likelihood of earning more than the poverty threshold. The esports labor market is an engine of inequality that provides opportunities for a few (primarily male) competitors while building a growing class of lowly paid players who support the interests of game designers and event organizers.

Underweight among adolescents in Denmark: prevalence, trends (1998-2018), and association of underweight with socioeconomic status.

Underweight among adolescents is an important clinical and public health issue. It is associated with adverse health outcomes throughout the life-span and may reflect food poverty, unhealthy eating habits, or some underlying health conditions. To study prevalence and trends in underweight among adolescents 1998-2018, to examine social inequality in underweight, and whether social inequality changed over time. Data were derived from 6 cross-sectional school surveys from The Health Behaviour in School-aged Children study in Denmark. The study included 11-, 13-, and 15-year-old schoolchildren in random samples of schools in 1998, 2002, 2006, 2010, 2014, and 2018 (n = 22,177). Underweight was determined by body mass index-for-age thinness grade 2-3 (the Cole and Lobstein method). Socioeconomic status was determined using occupational social class (the Danish OSC Measurement). The overall prevalence of underweight was 3.1% among boys and 5.3% among girls (P < 0.0001) and decreased by age (P < 0.0001) among both boys and girls. The prevalence of underweight was almost stable from 1998 to 2018. There was no observed absolute or relative social inequality in the prevalence of underweight among boys or girls. The prevalence of underweight in 11- to 15-year-olds was significantly higher among girls than boys. The prevalence remained stable from 1998 to 2018. There was no significant association between SES and prevalence of underweight. It is important to elucidate the underlying causes of underweight such as malnutrition, eating disorders, eating problems, loss of appetite, chronic diseases, insufficient knowledge of nutrients effects on bodily functions, and persistent pain.

Inequalities in dental prenatal control in Colombia: An analysis based on the IV National Oral Health Study, 2013-2014

ResumenIntroducción. La atención odontológica es esencial para garantizar el derecho a una maternidad saludable. En Colombia, las políticas de atención prenatal incorporan la promoción, prevención y atención en salud bucal como parte de la atención integral que deben recibir las mujeres gestantes en el sistema de salud, sin embargo, no se hace un seguimiento sistemático del cumplimiento de estas directrices.Objetivo. Explorar la atención efectiva y las desigualdades sociales en la prestación y el uso del control odontológico prenatal en Colombia.Materiales y métodos. Estudio descriptivo con datos de las mujeres gestantes reportadas en el Cuarto Estudio Nacional de Salud Bucal, 2013-2014. Se estimaron las desigualdades sociales absolutas y relativas, según zona de residencia, pertenencia étnica, nivel educativo, régimen de afiliación a los servicios de salud y estrato socioeconómico. Resultados. Se analizaron los datos de 1.050 mujeres gestantes. El 88,37 % recibió control prenatal y, el 57,19 %, control odontológico. Se observó un patrón general de brechas sociales en el uso efectivo de este último servicio, principalmente en función del aseguramiento. Las mujeres gestantes con mayor posibilidad de recibir atención odontológica prenatal fueron aquellas con algún aseguramiento en salud (razón de prevalencias, RP=2,62; IC95% 2,12-3,12), residentes en zonas urbanas (RP=1,37; IC95% 1,18-1,56), con nivel educativo técnico o superior (RP=1,20; IC95% 1,02-1,38) o de estratos sociales medios o altos (RP=1,15; IC95% 1,01-1,29). Conclusiones. En Colombia, la prestación efectiva del control odontológico a mujeres gestantes como parte de la atención prenatal integral, sigue siendo un reto. Se requieren importantes esfuerzos para cumplir las normas y reducir las desigualdades sociales en el acceso a este servicio.

Persistent social inequality in low life satisfaction among adolescents in Denmark 2002–2018

PurposeThe aims were to examine social inequality in low life satisfaction among Danish adolescents and whether the social inequality changes over time. MethodsThe study population was 20,328 11-, 13- and 15-year-olds from the Danish Health Behaviour in School-aged Children (HBSC) study 2002, 2006, 2010, 2014 and 2018 with data about life satisfaction and occupational social class (OSC). Low life satisfaction was defined as values under 6 on the Cantril Ladder. ResultsThe proportion with low life satisfaction was 10.5% in high, 11.7% in medium and 14.7% in low OSC (chi2-test, p < 0.0001). The OR (95% CI) for low life satisfaction was 1.25 (1.13–1.39) in medium and 1.62 (1.43–1.83) in low compared to high OSC. There was no upwards or downwards trend in low life satisfaction over time and the absolute and relative social inequality in low life satisfaction did not change from 2002 to 2018. ConclusionThe study shows that the political ambition on reducing social inequality in health and wellbeing has not been met in relation to low life satisfaction among Danish adolescents.

Trends in social inequality in overweight and obesity among adolescents in Denmark 1998-2018.

The aim was to analyze trends in overweight and obesity in relation to socioeconomic position among Danish adolescents in the 20-year period 1998-2018. The study used data on self-reported height and weight and parents' occupational social class (OSC) from 11-, 13- and 15-year-old schoolchildren in 1998, 2002, 2006, 2010, 2014 and 2018, n = 22,177. The analyses included absolute social inequality in overweight/obesity (prevalence difference between low and high OSC) and relative social inequality (OR for overweight/obesity). In the total sample, the prevalence of overweight and obesity was 9.7% and 1.4%, respectively, with significantly higher prevalence in low than high OSC. There were significantly increasing trends in both overweight and obesity 1998-2018 in low OSC and no significant increase in high OSC. The OR for overweight was 1.59 (1.42-1.74) in middle and 2.16 (1.89-2.46) in low OSC, OR for obesity 1.74 (1.29-2.34) in middle and 2.97 (2.15-4.11) in low OSC. Associations were not modified by survey year. There was a persistent absolute and relative social inequality in overweight and obesity 1998-2018 among Danish adolescents.

Difficulties falling asleep among adolescents: Social inequality and time trends 1991-2018.

Sleep problems in adolescence are increasingly common, and associated with adverse health and psychological outcomes. Adolescents' sleep problems may be related to the family's socioeconomic status, but studies are few and no study has examined whether social inequality in sleep problems changes as sleep problems become increasingly common. This study examined trends in difficulties falling asleep among adolescents in Denmark, whether this sleep problem was associated with socioeconomic status, and whether this association changed from 1991 to 2018. The study applied data from eight comparable surveys among 11-15 year olds in Denmark 1991-2018, the Danish arm of the international Health Behaviour in School-aged Children study, N=30,002. The prevalence of daily difficulties falling asleep increased from 7.0% to 13.4% in 1991-2018 with higher frequencies among girls and younger adolescents. The odds ratio (95% confidence interval) for daily difficulties was 1.14 (1.05-1.24) in middle and 1.52 (1.37-1.69) in low compared with high socioeconomic status. The absolute social inequality in difficulties falling asleep was persistent in 1991-2018 whereas the relative social inequality may have decreased. The increasing prevalence and the social inequality in difficulties falling asleep among adolescents is a serious public health concern that calls for more attention and efforts.

Determinants of childhood immunizations in Senegal: Adding previous shots to sociodemographic background

ABSTRACTIntroduction. Today, in Sub-Saharan Africa, vaccine-preventable diseases still contribute heavily to high child mortality. Maintaining high coverage rates for childhood vaccines and reducing related social inequalities are public health priorities in Senegal. Our aim was to investigate the determinants of childhood vaccination, including sociodemographic factors and previous vaccine-related decision-making.Methods. Data come from the 2016 Senegalese Demographic and Health Survey, a nationally representative household survey targeting women aged 15–49, with a questionnaire focusing on health and reproductive issues, including their children’s health. We restricted the analysis to children aged 12–23 months (n = 1,143). We used bivariate and multivariate analyses for investigating the determinants of several childhood vaccinations (Bacillus Calmette-Guérin, pentavalent, polio, measles and yellow fever vaccines), including sociodemographic factors and previous shots.Results. We identified two main sociodemographic predictors of childhood vaccination in Senegal: the mother’s education level, which was strongly and positively correlated to every vaccination considered, except from the BCG vaccination, and the region of residence, with higher vaccination coverage rates in the Centre and West of Senegal. Moreover, previous shots were also strongly predictive of subsequent shots.Conclusion. The positive impact of mother’s education on child vaccination illustrates the wide-ranging benefits of educating girls, while the regional variability of immunization rates requires more research to be better understood. Previous shots are probably a proxy variable for unobservable factors strongly correlated to vaccinations, but beyond this ‘proxy effect’, they may also have their own specific effect on following shots. We believe this topic deserves further research.

Trends in Social Inequality in Exposure to Bullying at School 1994-2018

Aims: To examine social inequality in exposure to bullying at school among adolescents and changes in social inequality over time. We applied data from seven nationally representative school surveys in 1994, 1998, 2002, 2006, 2010, 2014 and 2018 in Denmark, the Health Behaviour in School-aged Children (HBSC) study.&#x0D; Methodology: The study population was 11-, 13- and 15-year-olds, response rate 87.9%, N=33,460 with comparable data about exposure to bullying and socioeconomic status. The analyses included 1) absolute social inequality, i.e. percent difference in exposure to bullying between low and high socioeconomic groups and 2) relative social inequality based on logistic regression analyses with odds ratios for exposure to bullying by socioeconomic background.&#x0D; Results: The prevalence of exposure to bullying decreased from 24.4% in 1994 to 4.9% in 2018. Bullying was significantly most prevalent among schoolchildren from lower socioeconomic groups. The absolute social inequality decreased from 10.7% in 1994 to 3.9% in 2018. The relative social inequality was 1.30 (1.19-1.43) in middle and 1.77 (1.59-1.96) in low socioeconomic group, compared to high. There was no significant change in relative social inequality from 1994 to 2018.&#x0D; Conclusion: In the period 1994 to 2018 with substantial reduction in exposure to bullying at school there was a decrease in the absolute social inequality and an unchanged relative social inequality in exposure to bullying.

Relative social inequality in the world: Rigidity against the economic growth, 1992–2016

The study of economic growth and social inequality goes back to the works of S. Kuznets, A. Atkinson, P. Krugman, J. Stiglitz, T. Piketti, and B. Milanovic. Statistical analysis of social inequalities for a large set of countries, divided into seven clusters, was conducted for the period 2000–2016. The share of incomes of the 10th decile was used as a measure of inequality. The hypothesis of the positive impact of economic growth on the reduction of social inequality was tested. Stylized facts on an array of 106 countries for the period under review indicate a high degree of stability of the level of inequality in most groups, especially in the most developed countries, and in particular in the Anglo-Saxon ones. The distribution of key socioeconomic and even political indicators for clusters shows their strong relationship with the structure of cluster inequality. This makes it possible to significantly deepen the analysis, in particular the one concerning the stages of world development.

Are There Changes in Inequalities in Injuries? A Review of Evidence in the WHO European Region.

Decreases in injury rates globally and in Europe in the past decades, although encouraging, may mask previously reported social inequalities between and within countries that persist or even increase. European research on this issue has not been systematically reviewed, which is the aim of this article. Between and within-country studies from the WHO European Region that investigate changes in social inequalities in injuries over time or in recent decades were sought in PubMed, Scopus, and Web of Science. Of the 27 studies retained, seven were cross-country and 20 were country-specific. Twelve reported changes in inequalities over time and the remaining 15 shed light on other aspects of inequalities. A substantial downward trend in injuries is reported for all causes and cause-specific ones—alongside persisting inequalities between countries and, in a majority of studies, within countries. Studies investigate diverse questions in different population groups. Depending on the social measure and injury outcome considered, many report inequalities in injuries albeit to a varying degree. Despite the downward trends in risk levels, relative social inequalities in injuries remain a persisting public health issue in the European Region.

Short report: persistent social inequality in poor self-rated health among adolescents in Denmark 1991-2014.

The aim was to examine trends in social inequality in poor self-rated health (SRH) among adolescents in Denmark 1991-2014. The analysis included 18 996 11-15-year-old school children from the cross-sectional Health Behaviour in School-aged Children studies in 1991, 2002, 2006, 2010 and 2014. Across the five surveys, the prevalence of poor SRH was 14.2%, remaining almost unchanged from 1991 to 2014. The proportion with poor SRH was 12.2% in high, 14.3% in middle and 17.6% in low occupational social class. This social inequality in poor SRH was persistent during the entire study period, both in terms of absolute and relative social inequality.

Trends in social inequality in loneliness among adolescents 1991-2014.

Loneliness and social inequality in health are important public health concerns. We examined (i) trends in loneliness among adolescents from 1991 to 2014 in Denmark and (ii) trends in social inequality in loneliness. Study population: 11-15-year olds in random samples of schools in 1991, 1994, 1998, 2006 and 2014, n = 19 096. Loneliness was measured by a single item and social background by parents' occupational social class (OSC). We calculated absolute (%) differences in loneliness between high and low OSC and relative differences by odds ratio for loneliness. Across all surveys, 6.3% reported feeling lonely. The prevalence increased from 4.4% in 1991 to 7.2% in 2014. The prevalence of loneliness in high, middle and low OSC was 5.8, 5.9 and 8.0%. The increase in loneliness was more pronounced in higher than lower OSC, resulting in a decreasing absolute social inequality in loneliness. The statistical interaction between OSC and survey year was significant, P = 0.0176, i.e. the relative social inequality in loneliness also decreased from 1991 to 2014. The prevalence of loneliness increased from 1991 to 2014. The social inequality in loneliness decreased in both absolute and relative terms because of a rising prevalence of loneliness among children from high OSC.

Brief Report: Trends in Social Inequality in Drunkenness Among Danish Adolescents, 1991–2014

This study examined whether social inequality in frequent drunkenness among Danish adolescents changed from 1991 to 2014. We used data from the international Health Behaviour in School-aged Children (HBSC) study, which provided nationally representative samples of 15-year-olds from seven comparable cross-sectional studies in Denmark (N = 8,655). The students provided data about frequency of drunkenness and parents' occupation. In total, 38.6% reported to have been drunk at least four times, decreasing from 44.2% in 1991 to 21.2% in 2014. Most of the decrease took place in the latter part of the period. This decrease was found in all occupational social classes, but there was no change in absolute social inequality in drunkenness four or more times reported from 1991 to 2014. The sex- and yearadjusted odds ratio for frequent drunkenness was 0.80, 95% CI [0.70, 0.93] in low compared with high occupational social class. The statistical interaction between survey year and occupational social class was insignificant (p = .3601); that is, there was no change in relative social inequality in frequent drunkenness over time. Drunkenness was more prevalent among adolescents from the high occupational social class, and this social inequality did not change from 1991 to 2014.