Socioeconomic Inequalities Research Articles

Socioeconomic inequalities in high-risk fertility behaviour among Nigerian women: A non-experimental population-based study

Background High-risk fertility behaviour (HRFB) has adverse health, social and economic effects on women. An understanding of socioeconomic inequalities is needed to design effective interventions targeted to lower maternal morbidity and mortality due to HRFB. Objectives The objective was to quantify socioeconomic inequalities in HRFB among Nigerian women. Design This was a cross-section study that used population-based data. Methods A sample of 21,792 Nigerian women aged 15–49 years from the 2018 Nigeria Demographic Health Survey was analyzed. Percentage was employed in univariate analysis. In addition, concentration index was used to assess the extent of inequalities in HRFB. This was further decomposed to ascertain the explanatory components’ relative contributions to the socioeconomic inequalities in HRFB. Results The weighted prevalence of HRFB (63.5%; 95% CI: 62.6–64.4%), included <18 years at childbirth (4.9%; 95% CI:4.5–5.3%), >34 years at childbirth (18.3%; 95% CI: 17.6–19.0%), >3 children birth order (49.6%; 95% CI: 48.7–50.5%) and <24 months at preceding birth interval (17.0% 95% CI: 16.3–17.6%) were estimated. Education (Contri: 50.3997%, Ec: 0.2771), wealth (Contri: 27.2811%, Ec: 0.2665), socioeconomic disadvantaged (Contri: 14.9163%, Ec: -0.0996), religion (Contri: 13.8636%, Ec: -0.0496), region (Contri: 11.1724%, Ec: 0.0711), partner education (Contri: 7.1351%, Ec: 0.2138), media use (Contri: 4.5064%, Ec: 0.1449) and family motility (Contri: 3.7890%, Ec: -0.0281) were positive contributors to HRFBs among Nigerian women. However, age (Contri: -14.6237, Ec: 0.0089) and history of contraceptive use (Contri: -8.7723, Ec: -0.2094) were negative contributors to HRFBs among women of reproductive age in Nigeria. Conclusion Women who have low socioeconomic level reported higher prevalence of HRFB. Targeted interventions are required to lower HRFB among Nigerian women from poor households and with no formal education. Women should get counselling and assistance from healthcare and educational institutions to help them adopt healthy sexual and reproductive practices.

Road Traffic Injury Prevention: Bicycle

Abstract Purpose of review We describe recent trends in bicycle-related trauma, associated morbidity and mortality, the disparate effects on adult and pediatric populations, the effects of socioeconomic inequities on injury patterns, and milestones in preventative efforts. Recent findings National data demonstrates a lower incidence of unintentional injuries but a higher number of bicycle-related fatalities in the United States over the past decade. Traumatic brain injury remains the leading cause of mortality and chronic morbidity for bicyclists overall. Extremity and facial trauma predominate among older populations, while children are more susceptible to solid organ injuries and severe trauma with the use of electric bicycles. Factors that improve rider safety include changes in infrastructure, speed limits, and the implementation of dedicated bicycle lanes. Helmet usage is the most critical aspect for reducing bicyclist mortality, though rates of consistent usage in the US remain low, they can be improved with mandatory helmet laws. The lowest rates of helmet use are seen in areas of lower socioeconomic status, with these bicyclists subsequently subject to a greater burden of bicycle-related trauma. Summary Bicycle accidents are relatively common injuries in both adults and children. Road traffic accidents (RTAs), including those involving bicycles and electric bicycles (E-bikes), contributing significantly to morbidity and mortality across age groups. The focus in mitigating these injuries is on preventive measures, emphasizing the role of infrastructure improvements, public policies, and educational initiatives. The review discusses the trends in bicycle-related trauma, disparities affecting different age groups, socioeconomic influences on injury patterns, and recent advancements in injury prevention strategies.

IMPACTO DA PNEUMONIA NA MORTALIDADE INFANTIL: ANÁLISE HOSPITALAR NO ESTADO DA BAHIA

Introduction: Pneumonia is a severe respiratory infection, often caused by bacteria, viruses, or fungi, that primarily affects the lungs and can impair gas exchange, leading to respiratory difficulties. In Brazil, pneumonia presents a significant public health challenge, with a particular impact on children under five years of age. This issue is especially evident in the state of Bahia, where the infant mortality rate due to pneumonia is one of the highest in the country. The causes of this high mortality are linked to a combination of factors such as lack of access to adequate medical care, low vaccination coverage, poor living conditions, overcrowded homes, and insufficient air quality. Objectives: The main objective of this study is to analyze the impact of pneumonia on infant mortality in the state of Bahia, focusing on hospital data analysis between 2020 and 2024. The research aims to identify the epidemiological trends of the disease, understand the associated risk factors, and encourage the implementation of public policies to reduce infant mortality caused by pneumonia. Justification: This research is relevant to public health because it highlights the persistent high rates of infant mortality due to pneumonia, a critical issue in socially vulnerable areas. The study contributes to understanding the social, economic, and healthcare access factors affecting the child population in Bahia, providing essential data for more effective public health policies. Methodology: The study is of an epidemiological nature, using a quantitative approach. Data were collected from records of pediatric pneumonia cases provided by the Health Department of the State of Bahia (SESAB) and DATASUS, covering the period from 2020 to 2024. Data on incidence, mortality, demographic characteristics (age, sex, race/ethnicity), and regional conditions were analyzed. The analysis was performed using descriptive statistics and techniques such as calculating mortality rates and identifying risk factors. Results and Discussion: The data revealed that between January 2020 and September 2024, there were 295 deaths due to pneumonia in children in Bahia. The highest mortality was observed in the age groups under 1 year (33.6%) and 1 to 4 years (37.3%), indicating extreme vulnerability of these age groups to the disease. Additionally, pneumonia mortality was higher among children of mixed-race (parda) background (76.3%), reflecting socioeconomic and healthcare access inequalities, particularly in peripheral and rural areas. A slight predominance of deaths among girls was also observed, though the gender difference was small (2.37%). Conclusion: This study highlights the social and regional inequalities contributing to high infant mortality from pneumonia in Bahia, emphasizing the difficulties in accessing healthcare services in more vulnerable areas. The analysis revealed that children under 5 years of age, especially those under 1 year old, are the most affected. To reduce these rates, it is urgent to implement public policies focused on improving healthcare access, expanding vaccination coverage, and strengthening living conditions in the most underserved areas of Bahia.

Are area-level socioeconomic inequalities in obesity moderated by neighbourhood greenery?

Reducing socioeconomic inequalities in obesity is a public health priority. Limited research exists on the role of neighbourhood environmental attributes in mitigating these inequalities. However, it has been shown that neighbourhoods with more greenery tend to have lower levels of socioeconomic inequalities in non-obesity health outcomes. We examined whether neighbourhood greenery moderates the association of area-level socioeconomic status (SES) with waist circumference. Data from 3,261 middle-aged and older adults who participated in a national cohort study conducted in Australia (2011-12) were used. The outcome was objectively measured waist circumference. For area-level SES, a composite index of disadvantage based on census data was used. We used two measures of neighbourhood greenery: mean greenness and geographic size of greenspace. They were assessed using the Normalized Difference Vegetation Index (NDVI) within 0.5, 1, and 2km radius buffers around participants' homes. The mean NDVI value within each buffer area was used for the former, and the geographic size of the area with NDVI ≥ 0.6 (dense greenery) was used for the latter. There was a significant negative association between area-level SES and waist circumference: one standard deviation higher score in the area-level SES indicator (less disadvantage) was associated with 1.76cm (95% CI: -2.68, -0.83) lower waist circumference. Analyses stratified by greenery levels found similar significant associations in the areas with low and high levels of greenery but not in the areas with medium levels of greenery for both greenery measures within 1km and 2km buffers. Consistent with previous studies, our study found that participants living in disadvantaged suburbs were likely to have a larger waist circumference than those living in advantaged suburbs. However, we also found that such socioeconomic inequalities in obesity were mitigated in the areas with medium levels of greenery for this sample of Australian adults. Our findings suggest that there may be an optimum level of greenery where inequalities in obesity are alleviated. Further research is needed to understand the mechanisms underlying these findings.

Health Disparities and Inequities in the Utilization of Proton Therapy for Prostate Cancer

Our study sought to review and summarize the reported health disparities and inequities in the utilization of proton beam therapy (PBT) for prostate cancer. We queried the PubMed search engine through 12/2023 for original publications examining disparate utilization of PBT for prostate cancer. The query terms included the following: prostate cancer AND proton AND (disparities OR IMRT OR race OR insurance OR socioeconomic OR inequities)”. Studies were included if they involved United States patients, examined PBT in prostate cancer, and addressed health inequities. From this query, 22 studies met the inclusion criteria, comprising 13 population-based analyses, 5 single-institutional analyses, 3 cost/modeling investigations, and 1 survey-based study. The analyses revealed that in addition to age-related and insurance-related disparities, race and socioeconomic status played significant roles in the receipt of PBT. The likelihood of receiving PBT was lower for non-White patients in population-based and single-institution analyses. Socioeconomic metrics, such as higher median income and higher education level, portended an increased likelihood of receiving PBT. Conclusively, substantial age-based, racial, socioeconomic/insurance-related, and facility-associated disparities and inequities existed for PBT utilization in prostate cancer. The identification of these disparities provides a framework to better address these as the utility of PBT continues to expand across the US and globally.

Utilization of early therapeutic supports by autistic preschoolers in Australia: A cross-sectional study following implementation of the National Disability Insurance Scheme.

There are many types of support for young autistic children and their families, but service use in this population is not well understood. In this study, primary caregivers of autistic preschoolers were surveyed (n = 95) and a selection were then interviewed (n = 19) to understand how early, therapeutic supports were accessed by families in Australia following the establishment of a National Disability Insurance Scheme (NDIS). This article presents the quantitative data from surveys and interviews. Families usually accessed at least two types of support. The most accessed supports were occupational therapy, speech pathology and psychology, with 43% of the sample accessing some other form of support. Multiple linear regression indicated that children's higher level of support need, living in less remote or less socio-economically disadvantaged areas, and high household income were associated with higher numbers of supports accessed. Services tended to follow an individual, clinic-based model and little use of alternative service delivery was reported. The findings indicate that Australian families are accessing a wider range of support types than before the NDIS and children with more substantial autism-related support needs are likely to access a greater number of types of supports. Socio-economic inequities continue to exist and should be addressed.

The role of neighborhood on preterm birth among a high-risk group of birthing people in Boston, MA.

Preterm birth (PTB) is associated with adverse short- and long-term health. There are known racial, ethnic, and socioeconomic inequities in PTB. Because of historical de jure and modern-day de facto segregation and neighborhood divestment, neighborhoods are a source of structural racism and disenfranchisement and a potential target for policies and interventions to reduce PTB inequity. However, the role of neighborhoods on PTB, specifically among high-risk birthing people, is largely unexplored. The Boston Birth Cohort is a longitudinal birth cohort of birthing people-infant dyads at a safety-net hospital in Boston, MA between 2000 and 2018. The primary outcome was preterm birth at 35 weeks or prior. The primary predictor was neighborhood defined by census tract. We used generalized linear mixed effects models to test our hypothesis that neighborhood accounts for a signficiant proportion of PTB risk among socially at-risk birthing people. In multilevel models, neighborhoods were a significant predictor of preterm birth, yet accounted for only 3% of the variability in outcome. In models stratified by race, individual-level factors such as prior preterm birth, nativity status, and advanced birthing person age were significant predictors of PTB. Neighborhood is a significant, though small, predictor of preterm birth in a high-risk birthing population. These findings suggest that individual-level interventions, rather than neighborhood-level policies, may be more effective in reducing preterm birth among high-risk birthing populations.

No Socioeconomic Inequalities in Mortality among Catholic Monks: A Quasi-Experiment Providing Evidence for the Fundamental Cause Theory.

We propose a novel approach to test the fundamental cause theory (FCT) by analyzing the association between socioeconomic status (SES), as measured by the order titles "brothers" and "padres," and mortality in 2,421 German Catholic monks born between 1840 and 1959. This quasi-experiment allows us to study the effect of SES on mortality in a population with largely standardized living conditions. Mortality analyses based on Kaplan-Meier product limit estimation show that there were no statistically significant survival differences between the high and lower SES monks. This holds for all birth cohorts, indicating that monastic life offers health protection for monks with a lower SES regardless the disease patterns, causes of death, or main risk factors in a given period. These findings support the FCT: Whereas SES-related differences in mortality are a widely confirmed finding in the general population, a context with largely standardized conditions eliminates the importance of SES-related resources.

Poverty induced inequality in nutrition among children born during 2010-2021 in India.

Almost two-fifth of the children in India is stunted and among various factors, poverty differential in child undernutrition is the largest. Using the latest population-based survey of National Family Health Survey, 2015-16 and 2019-21 this paper examined the poverty induced inequality in child stunting across the sub-populations of India. A sample of 213,136 children aged between 0-5 years from NFHS fourth round and 98,222 children in the same age group from the NFHS fifth round constitute the study sample. The wealth index is used as the proxy of household's economic wellbeing and height-for-age (HAZ) z-score of a child is used to identify the stunting status of the child. Box plots are drawn to understand the distributional characteristics of the HAZ score for both the study sample. We calculate the Erreygers corrected concentration index and decomposed the concentration indices using Gonzalo-Almorox and Urbanos-Garrido method. During 2015-16, more than half of the children from the poorest wealth quintile were stunted (52%), compared to 22% among the children from richest wealth quintile. In 2015-16, stunting was as high as 65% among the children of mothers with low stature (height less than 145 cm) and from the poorest wealth quintile whereas, the prevalence was observed 56% from the same sub-population during 2019-21. Among various factors, the concentration index of stunting was observed highest among the children of 36-47 months (-0.28) followed by children of age 48-59 months (-0.27) and among the fully immunized children (-0.25). Similar to NFHS-4, NFHS-5 also shows a predominantly higher socio-economic inequality among 24+ months children and among the fully immunised children. Factors like child age, birth order and sanitation showed positive elasticity. Decomposition analysis of NFHS-4 data shows that due to uneven distribution of wealth, mother's education as a determinant of child stunting solely explained 33% of the overall inequality followed by improved access to sanitation (24%), mother's height (8%) and place of residence (5%). Similar to NFHS-4, NFHS-5 data also shows that mother's education, sanitation, mother's height and place of residence predominantly contributes to the overall wealth inequality in child stunting. In India, poverty differential in child undernutrition is acute among the different sub-population of children. And the concentration of stunted children is higher among the different sub-population with higher wealth poverty. Mother's education, improved sanitation and mother's height explained larger variation in the overall inequalities in child nutrition across India.

OGC O06 - Socioeconomic Health Inequality in Oesophago-gastric Cancer in a Single Tertiary Centre: On Behalf of Greater Manchester OG Unit

Abstract Background Oesophagogastric cancer (OGC) 5-year survival is poor (15%). Only 34% of patients are considered for potentially curative treatment, which is associated with a 41% chance of survival. In other cancer, deprivation is associated with poor outcomes. This study aims to determine the association between deprivation, tumour and treatment intent (TI), and 5-year all-cause mortality (M) in OGC. Method This retrospective cohort study analysed patients newly diagnosed with OGC (adenocarcinoma or squamous cell carcinoma) across Greater Manchester between January 2018 and January 2023. TI was defined as the treatment pathway, at completion of staging investigations, either curative (pathway to resection or definitive chemoradiotherapy) or palliative (best supportive care, palliative chemotherapy or radiotherapy). Statistical analysis encompassed methods such as binary logistic regression, Cox proportional hazards models and Kaplan-Meier survival curves with adjustments made for age, gender, and clinical stage. IMD scores were grouped from deciles into quintiles leaving 5 groups, with IMD1 representing the most deprived. Results 3027 patients were included (2102, 69.4% males). Patients in IMD1 were diagnosed 4 years younger than in IMD5 (most affluent) (median age 70 (IQR=17) vs 74 (IQR=16), p<0.001). There was a higher proportion of deprived patients (32.9% IMD1 vs 15.3% IMD5, p<0.001). The proportion of stage 4b disease in IMD1 compared with IMD5 was not different (406 (40.7%) vs 174 (37.5%), p=0.081). The median survival was lower in IMD1 compared with IMD5 (0.81 vs 0.90 years, p=0.074). Following adjustment for confounders IMD1 was associated with a poorer overall survival when compared with IMD5 (HR 1.16, CI[1.02-1.32],p=0.020). Conclusion This study highlights a significant health inequality in the outcomes of OGC. Poorer outcomes in the most deprived group were independent of tumour stage, gender and age. Urgent measures to address socioeconomic health inequalities need to be instigated.

Socioeconomic Inequality in Perceived Need for Mental Healthcare in Patients with Type 2 Diabetes Mellitus in Hamadan, Western Iran

Background and aims: The use of mental healthcare services in type 2 diabetes mellitus (T2DM) patients can depend on socioeconomic status (SES). The current study aimed to evaluate socioeconomic inequality in the perceived need for mental healthcare in patients with T2DM in Hamadan, Western Iran. Methods: This cross-sectional study was conducted between March and July 2023 in Hamadan, Western Iran. The study included T2DM patients who were referred to the Diabetes Center of Hamadan. The variables included in the study were demographics, SES, health insurance status, social support, and self-rated mental health. The outcome of interest was the perceived need for mental healthcare. The socioeconomic inequality was evaluated using concentration index and decomposition analysis. Results: A total of 393 patients (mean age: 56.48±10.65, 62% female and 88% urban inhabitants) were enrolled. The prevalence of perceived need for mental healthcare was 43%, and 50.30% of the patients (85) had delay/avoidance of mental healthcare services. The concentration index (95% confidence interval) of perceived mental healthcare needs was -0.24 (-0.18, -0.30), indicating that perceived needs are more concentrated in the socio-economically disadvantaged patients. Decomposition analysis revealed that low economic status and illiteracy were the main contributors to the inequality (approximately 50%). Cost, minimization, and stigma were the most frequently reported reasons for avoidance/delay of mental healthcare services, respectively. Conclusion: There was a pro-poor socioeconomic inequality in perceived need for mental healthcare among T2DM patients. Healthcare policies and facilities to reduce socioeconomic inequality should mainly focus on disadvantaged T2DM patients.

Socioeconomic Inequalities in Out-of-Pocket and Catastrophic Health Expenditures in Pakistan

ObjectivesIn Pakistan, healthcare utilization is linked to out-of-pocket payments (OOP) which disproportionately affect low-income households. We investigated socioeconomic inequality in OOP and catastrophic health expenditures (CHEs), and the contribution of sociodemographic factors to these inequalities.MethodsSocioeconomic inequalities were quantified using the concentration index (CI), and the slope (SII) and relative (RII) indices of inequality using data from three rounds of Household Integrated Economic Survey (2007-08, 2011-12, and 2018-19). Decomposition analyses were conducted using the Wagstaff and Erreygers approach.ResultsOOP payments increased from PKR 127 (2007-08) to PKR 250 (2018-19). CHEs in the most deprived quintile (Q1) changed from 8.3% (2007-08) to 13.7% (2018-19), and for the least deprived quintile (Q5) from 5.1% (2007-08) to 8.4% (2018-19). The OOP CI increased from 0.028 to 0.051, while the SII and RII increased from 0.89 to 1.32 and 1.18 to 1.36, respectively. Decomposition analysis showed that household size, composition, employment, and the province of residence explained much of the socioeconomic inequality in CHEs.ConclusionPoor households experience high CHE, disproportionately impacting larger families with children and elderly members. Policymakers should implement targeted financial protection strategies to safeguard vulnerable households from the impoverishing effects of healthcare expenses.

Abstract 4133324: Socioeconomic status, race, and ethnicity in management of pediatric SVT

Introduction: Electrophysiology study and ablation (EPS) is often the preferred approach to management of supraventricular tachycardia (SVT) and/or ventricular pre-excitation (WPW) in older children/adolescents. There are inequities in arrhythmia management in adults, and in other areas of pediatric cardiology, but little is known about disparities in management of SVT in children. Research question: Do racial/ethnic and socioeconomic inequities affect referral for EPS in patients with SVT and/or WPW? Methods: This retrospective observational study utilized the Pediatric Health Information System of 49 children’s hospitals’ administrative data from 2016-2022. We included patients with SVT or WPW seen in the emergency department, admitted for observation, or inpatient. We excluded patients with congenital heart disease. The outcome was having a procedure code for EPS. The childhood opportunity index (COI, scale 1-100) based on zip code was used to measure socioeconomic status (SES). Results: Among 37,818 patients with primary diagnosis of SVT (27620, 73%) or WPW (10198, 27%), 9840 (26%) underwent EPS (Table 1). COI was higher in patients who underwent EPS than those who did not (median 59 [IQR 34,82] vs 57 [IQR 30,81]). In addition, time from initial visit with diagnosis of SVT/WPW to EPS was longer in patients with lower COI (beta= -0.026, p=0.007). Black (21.2%), Hispanic (23.8%), and American Indian (19.8%) patients were less likely to undergo EPS than White (26.5%) and Asian (28.31%) patients and those with other (28.4%) or unknown/missing (35.7%) race (p<0.001, Figure 1). In both subgroups of patients with SVT and WPW, EPS differed by race and COI, and higher COI predicted shorter time to EPS. Conclusions: In this hospital database of pediatric patients, we found disparities in use of EPS for the management of SVT and/or WPW. Patients of minoritized race/ethnicity and lower SES were less likely to undergo EPS.

Effect of a multicomponent school-based intervention with parental involvement on socioeconomic inequalities in smoking initiation: equity impact analysis of the TOPAS study

BackgroundAs prevalence of tobacco use falls, socioeconomic inequalities in tobacco use are increasing in many high-income countries. Evidence is lacking on the effect of preventive interventions on socioeconomic inequalities in...

Alleviating the public health burden of hypertension: debating precision prevention as a possible solution

ABSTRACT Hypertension is a major global health concern, with deaths attributed to the condition expected to increase to 1.57 million by 2034, particularly affecting low-and-middle-income countries such as those within sub-Saharan Africa. Non-communicable diseases, with hypertension as a core contributor, account for 74.36% of global deaths. The burden of hypertension in sub-Saharan Africa is significant, with an estimated 10–20 million people currently affected. Systemic barriers, such as fragmented health services and socioeconomic inequalities, coupled with shifts in greater salt-intake, ultra-processed foods, more sedentary lifestyles, and overburdened healthcare services, have exacerbated elevated blood pressure and poorer management of people living with hypertension in sub-Saharan Africa. Most public health strategies focus on detecting, treating, and controlling hypertension through lifestyle modifications and medication. However, evidence suggests only 10% of population hypertension is well managed. This indicates a growing need to shift towards preventative efforts. Precision prevention, a tailored health intervention approach utilising individual and population-specific factors – genetic, environmental, and social determinants – offers a potential alternative. Precision prevention aims to deliver the right preventative measures to the right population at the right time, promising to enhance intervention efficiency and health outcomes. This paper highlights various intervention levers, including environmental, biological, and behavioural modifications, examines case studies from high-income countries, and discusses the potential for implementing precision prevention in South Africa. While precision prevention shows promise, we also discuss the significant barriers to its implementation in LMICs such as those within sub-Saharan Africa.

Cyclical Inclusive Growth Model of the European Union

This article analyzes the distinctive features of the contemporary cyclical inclusive growth model within the European Union (EU). As an integration entity, the EU contends with a series of internal challenges that impede its development, arising from the divergent economic interests of member states and the uneven distribution of the costs and benefits of the 'twin transition' in the context of Europe’s declining global competitiveness. Exploring the nuances of inclusive growth in the EU, particularly the role of citizen participation in societal progress, offers a valuable framework for understanding the social and economic contradictions both within and between member states. The study commences with a critical review of existing definitions of inclusive growth, laying the groundwork for an in-depth analysis of the EU model.The research employs quantitative methods to compare EU member states using the UNCTAD Inclusive Growth Index and additional indicators of social and economic development and well-being. It also evaluates the outcomes of the 'Europe 2020' strategy, which aimed to establish inclusive growth targets for the EU by 2020. The findings reveal that the highest levels of inclusive growth are concentrated in northern and continental European countries, whereas Central and Eastern Europe (CEE) exhibit significantly lower levels. The analysis further uncovers key contradictions, such as the tension between reducing socio-economic inequality and promoting economic growth, the generational conflict over the ‘green economy,’ and the misalignment of interests between smaller and larger EU economies.Despite the initiatives under the 'Europe 2020' strategy, the study observes a shift in the priorities of EU citizens concerning inclusive growth. The research identifies fundamental characteristics of the EU's inclusive growth model, marked by a cycle of emerging and resolving social and economic contradictions at the Union level. A notable aspect of this model is the increasing complexity and multiplicity of contradictions, alongside a growing emphasis on subjective well-being and the fulfillment of intangible individual needs. The insights derived from this analysis have practical implications for developing inclusive growth support measures within the Eurasian Economic Union (EAEU) and can aid in defining priorities and mechanisms for the social and economic policies of EAEU member states.

Pitfalls of PTOs in land ownership and control: Rethinking access for rural development in South Africa

Permission to Occupy (PTOs) was viewed by the apartheid regime as an important mechanism for addressing inequalities in South Africa (SA). The African National Congress (ANC) government has ruled over SA for the past 30 years but has been unsuccessful in dealing with the country’s racialised land inequalities. The land reforms introduced by the ANC government have not addressed the challenges of land in the country in a timely manner. Thus, tackling the issue of land inequalities remains crucial. A desktop review was conducted to critically examine the pitfalls of PTOs in the context of rural development and advocates for a re-evaluation of access mechanisms to promote more equitable and sustainable land tenure systems. The results show that these pitfalls perpetuate socio-economic inequalities, hinder investment in land improvements, and contribute to conflicts over land resources. In response, the article proposes alternative approaches to enhance access to land for rural development, such as community-driven land governance mechanisms, participatory land-use planning, and the recognition of customary land tenure systems. These alternative strategies prioritise rural local empowerment, strengthen tenure security, and foster inclusive decision-making processes.

Predicting Prefecture-Level Well-Being Indicators in Japan Using Search Volumes in Internet Search Engines: Infodemiology Study.

In recent years, the adoption of well-being indicators by national governments and international organizations has emerged as an important tool for evaluating state governance and societal progress. Traditionally, well-being has been gauged primarily through economic metrics such as gross domestic product, which fall short of capturing multifaceted well-being, including socioeconomic inequalities, life satisfaction, and health status. Current well-being indicators, including both subjective and objective measures, offer a broader evaluation but face challenges such as high survey costs and difficulties in evaluating at regional levels within countries. The emergence of web log data as an alternative source of well-being indicators offers the potential for more cost-effective, timely, and less biased assessments. This study aimed to develop a model using internet search data to predict well-being indicators at the regional level in Japan, providing policy makers with a more accessible and cost-effective tool for assessing public well-being and making informed decisions. This study used the Regional Well-Being Index (RWI) for Japan, which evaluates prefectural well-being across 47 prefectures for the years 2010, 2013, 2016, and 2019, as the outcome variable. The RWI includes a comprehensive approach integrating both subjective and objective indicators across 11 domains, including income, job, and life satisfaction. Predictor variables included z score-normalized relative search volume (RSV) data from Google Trends for words relevant to each domain. Unrelated words were excluded from the analysis to ensure relevance. The Elastic Net methodology was applied to predict RWI using RSVs, with α balancing ridge and lasso effects and λ regulating their strengths. The model was optimized by cross-validation, determining the best mix and strength of regularization parameters to minimize prediction error. Root mean square errors (RMSE) and coefficients of determination (R2) were used to assess the model's predictive accuracy and fit. An analysis of Google Trends data yielded 275 words related to the RWI domains, and RSVs were collected for 211 words after filtering out irrelevant terms. The mean search frequencies for these words during 2010, 2013, 2016, and 2019 ranged from -1.587 to 3.902, with SDs between 3.025 and 0.053. The best Elastic Net model (α=0.1, λ=0.906, RMSE=1.290, and R2=0.904) was built using 2010-2016 training data and 2-13 variables per domain. Applied to 2019 test data, it yielded an RMSE of 2.328 and R2 of 0.665. This study demonstrates the effectiveness of using internet search log data through the Elastic Net machine learning method to predict the RWI in Japanese prefectures with high accuracy, offering a rapid and cost-efficient alternative to traditional survey approaches. This study highlights the potential of this methodology to provide foundational data for evidence-based policy making aimed at enhancing well-being.

Digital Divide: Examining Socioeconomic Inequalities in Internet Access and Usage

The term "digital divide" refers to the disparity that exists between those who have access to digital technologies, most notably the internet, and those who do not have such access. This disparity is caused by several socioeconomic, regional, and demographic reasons. The digital gap not only exacerbates existing disparities but also creates challenges for marginalized communities. This is because the Internet is becoming an increasingly vital instrument for education, communication, employment, and social involvement. The purpose of this review article is to analyze the underlying factors that contribute to these disparities, such as income, education, geographic location, and age, and to investigate the influence that uneven access to the internet has on different elements of contemporary life. In addition to this, it examines the policies and activities of the government, as well as the technical advancements that are being made to narrow this gap. Although attempts have been made to bridge the difference, the results imply that there is still a great deal of work to be done, especially in tackling structural inequities that continue to interfere with development. In conclusion, the article makes recommendations for comprehensive methods that aim to overcome socioeconomic obstacles and encourage fair access to Internet resources.

The fall and rise of parental financial investments during the COVID‐19 pandemic

AbstractObjectiveThis research note investigates changes in American parents' financial investments in children during the COVID‐19 pandemic, as well as whether and how changes in parents' spending varied based on parental education.BackgroundParents purchase goods, experiences, and services that shape children's human capital and life chances. Socioeconomic differences in parental expenditures on children represent an important pathway for perpetuating inequality across generations. The COVID‐19 pandemic disrupted children's lives in ways that may have changed these levels of investment.MethodThe 2015–2022 Consumer Expenditure Survey (CEX) is used to describe spending on five key categories of investments in children's human capital (educational spending, extracurricular activities and lessons, computers and tablets, formal childcare, informal childcare) overall and by parental education. Mediation analysis assesses the extent school closures explain these changes.ResultsChildcare and extracurricular expenditures initially decreased significantly and then gradually recovered to pre‐pandemic levels by the end of 2021. Cutbacks were primarily among more educated families. However, spending on schooling increased in 2021 and computer and tablet purchases spiked in 2020, particularly among more educated families. Mediation analysis suggests that when expenditures were most affected by the pandemic (in 2020), school closures explained 50%–70% of those changes.ConclusionThis note provides evidence that during the pandemic socioeconomic inequalities in child‐related spending decreased in some categories of spending (e.g., childcare and extracurriculars) and increased in others (e.g., computers and tablets). Many changes appeared short‐term, but changes in education point to possible longer‐term shifts in parents' preferences about children's educational environments.