Trends In Inequality Research Articles

Investigating the Inequality Trend in Health Resource Distribution in Iran: A Case Study in Bushehr Province

Background: Equity in access to health resources is a fundamental goal of health systems worldwide. Objectives: This study aims to assess the distribution of essential health resources necessary for healthcare provision in Bushehr Province. Methods: This cross-sectional study spans ten years and utilizes several widely recognized indices in health resource distribution equity and equality, including the Gini Coefficient, Concentration Index, Horizontal Inequity, Robin Hood Index, Theil Index, Atkinson Index, and Quantile Ratio. These indices were calculated based on both the population level and the proposed resource allocation model (PRAM) using Excel Software 2018 and Stata version 18. Results: The findings indicate a degree of inequality in the distribution of all health resources examined, with special beds exhibiting much higher levels of inequality than others. The sensitivity of the studied indices varied across the distributed resources. Moreover, the trend of inequality generally decreased for all examined resources. The PRAM results suggest that adopting a different approach to resource distribution can significantly reduce inequality levels. Conclusions: Despite a downward trend in the inequality of health resource distribution, significant disparities persist. Altering the resource distribution system from the conventional geographical division could aid in achieving equity and equality in healthcare. Such changes could also reduce the costs associated with the health system.

ANALISIS FAKTOR-FAKTOR YANG MEMPENGARUHI KETIMPANGAN PENDAPATAN DI JAWA TIMUR

The welfare of the community is the primary goal in the economic development of a region, and this can be achieved through rapid economic growth and equitable income distribution. In reality, East Java Province has not yet achieved equal prosperity, as evidenced by an increasing trend of inequality that has not reached its lowest point during the period of this research. Therefore, there is a need to accelerate the reduction of inequality by understanding the various factors influencing inequality in East Java. Through a simultaneous model using the three-stage least square (3SLS) method, this study attempts to estimate the impact of Gross Regional Domestic Product (PDRB) per capita and the health index on income inequality. It also analyzes the factors influencing the growth of PDRB per capita in East Java. The data used for this research is sourced from the Badan Pusat Statistik (BPS) for the years 2011-2021.The research findings indicate that the growth of PDRB per capita and the health index significantly and positively affect income inequality. The factors influencing the growth of PDRB per capita in East Java include the education index and capital accumulation. Based on these results, the government and relevant stakeholders need to promote a more even distribution across sectors in each region of East Java Province and strengthen health aspects for groups with low incomes.

The U-Shaped Curve of Health Inequalities Over the 20th and 21st Centuries.

This article examines historical trends in health inequalities over the 20th and 21st centuries. Drawing on studies from the United States, United Kingdom, Sweden, and Western Europe, it concludes that there is evidence of a u-shaped curve in (relative) health inequalities. These trends in health inequalities broadly parallel those identified by economists with regards to the u-shaped curve of income and wealth inequalities across the 20th and 21st centuries. The article argues that-as with income inequalities-health inequalities generally decreased across the twentieth century through to the early 1980s. They then started to increase and accelerated further from 2010, particularly in the United Kingdom and the United States. The article sets out four distinct policy periods that shaped the evolution of trends in health inequalities: the Interbellum Era, 1920-1950; the Trente Glorieuse, 1950-1980; Neoliberalism, 1980-2010; and the Crisis Age, 2010-present. The u-shaped curve of health inequalities over this period suggests that social policies, health care access, and political incorporation have driven changes over time. Taking this long view of changes in health inequalities emphasizes the importance of politics and policy for future health improvement.

The causes of income inequality in urban China: A household assets perspective

Despite income inequality in China being a heated topic in scholarship and public discussion, little research has explored the trend in income inequality since the mid-2010s or focused on the implications of household assets on income inequality. Using pooled cross-sectional data from the Chinese General Social Survey, we estimate income inequality at the household level from 2012 to 2021 and further examine the effects of two types of household assets (housing assets (HA) and financial assets (FA)) on income inequality in urban China, as well as the moderating effects of socioeconomic status (SES) and regional marketization. The results indicate that national income inequality was sustained at a high level between 2012 and 2021, while income inequality in urban households was higher than that in rural households. Both HA and FA were positively related to income inequality, and the latter assets had a stronger effect on income inequality. The association between the two types of household assets and income inequality strengthened along with an increase in family SES and regional marketization levels. The study highlights that FA, relative to HA, are a more important contributor to income inequality among urban households, thus extending the literature on inequality and social stratification in contemporary China by revealing the causes underlying rising income inequality from the household assets perspective.

Cause-of-Death Determinants of Lifespan Inequality

We propose a novel decomposition approach that breaks down the levels and trends of lifespan inequality as the sum of cause-of-death contributions. The suggested method shows whether the levels and changes in lifespan inequality are attributable to the levels and changes in (1) the extent of inequality in the cause-specific age-at-death distribution (the “Inequality” component), (2) the total share of deaths attributable to each cause (the “Proportion” component), or (3) the cause-specific mean age at death (the “Mean” component). This so-called Inequality–Proportion–Mean (or IPM) method is applied to 10 low-mortality countries in Europe. Our findings suggest that the most prevalent causes of death (in our setting, “circulatory system” and “neoplasms”) do not necessarily contribute the most to overall levels of lifespan inequality. In fact, “perinatal and congenital” causes are the strongest drivers of lifespan inequality declines. The contribution of the IPM components to changes in lifespan inequality varies considerably across causes, genders, and countries. Among the three components, the Mean one explains the least lifespan inequality dynamics, suggesting that shifts in cause-specific mean ages at death alone contributed little to changes in lifespan inequality.

Impact of Covid-19 on Income Inequality; a Comparative Analysis for China and Italy

This study examines the impact of covid 19 on income inequality and comparison between China and Italy. Trends in Gini coefficient showed differentiated results for two countries. In this comparison various indicators came to consideration that affected inequality. For empirical investigation from the past data collected from World Development Indicators and Generalized methods of moments (GMM) for panel data analysis. Results indicated that poverty and unemployment have significant positive impact on income inequality while rate of taxes shown negative and significant impact on income inequality. These results supported many other studies but the post covid trend in Gini coefficient shows contradictory results. Rising trend in income inequality in China and falling trend in Italy drives the attention in mitigation policies. China preferred to save its population from corona virus and implemented strict stay at home and isolation policy. In this regard inequality showed rising trend. Whereas Italian government along with isolation and stay at home policies financed poor much and paid less attention to rich. In this way the gap between rich and poor came down. This study pays attention to the country-based policies reflecting government preferences and initiatives taken for betterment.

Socioeconomic inequality and urban-rural disparity of antenatal care visits in Bangladesh: A trend and decomposition analysis.

Socioeconomic inequality in antenatal care visits is a great concern in developing countries including Bangladesh; however, there is a scarcity of investigation to assess the factors of inequality and these changes over time. In this study, we investigated the trend of socioeconomic inequalities (2004-2017) in 1+ANC and 4+ANC visits, and extracted determinants contributions to the observed inequalities and urban-rural disparities in Bangladesh over the period from 2011 to 2017. The data from the Bangladesh Demographic and Health Surveys (BDHS) conducted in 2004, 2007, 2011 and 2017 were analyzed in this study. The analysis began with exploratory and bivariate analysis, followed by the application of logistic regression models. To measure the inequalities, the Erreygers concentration index was used, and regression-based decomposition analyses were utilized to unravel the determinant's contribution to the observed inequalities. The Blinder-Oaxaca type decomposition is also used to decompose the urban-rural disparity into the factors. Our analysis results showed that the prevalence of 1+ANC and 4+ANC visits has increased across all the determinants, although the rate of 4+ANC visits remains notably low. The magnitudes of socioeconomic inequality in 4+ANC visits represented an irregular pattern at both the national and urban levels, whereas it increased gradually in rural Bangladesh. However, inequalities in 1+ANC visits declined substantially after 2011 across the national, rural and urban areas of Bangladesh. Decomposition analyses have suggested that wealth status, women's education, place of residence (only for 4+ANC visits), caesarean delivery, husband education, and watching television (TV) are the main determinants to attribute and changes in the level of inequality and urban-rural disparity between the years 2011 and 2017. According to the findings of our study, it is imperative for authorities to ensure antenatal care visits are more accessible for rural and underprivileged women. Additionally, should focus on delivering high-quality education, ensuring the completion of education, reducing income disparity as well as launching a program to enhance awareness about health facilities, and the impact of caesarean delivery.

Trends in out-of-pocket health expenditure inequality in Turkey under comprehensive health reforms

The success of Turkey's inclusive health policies has served as a strategic tool for building progressivity and improving social welfare. The objective of this study is to examine the inequality trend in out of pocket (OOP) health expenditures in Turkey. Data from the Turkish Statistical Institute's Household Budget Survey conducted in 2015 and 2019 were used to measure inequalities in OOP total health, pharmaceutical and hospital expenditure variables across socioeconomic status. Decomposition analysis was conducted to identify the factors contributing to inequalities. The study findings demonstrate that OOP health expenditure is higher among the poor in Turkey. Evidence suggests that in Turkey inequalities in OOP health expenditures continue to persist. The results show that OOP health, pharmaceutical, and hospital expenditures increased from 2015 to 2019. The inequality index and curve approaches reveal that the pro-rich distribution of OOP health expenditures is remarkable from 2015 to 2019. The burden of OOP pharmaceutical and hospital services expenditures stands on the shoulders of poor households. Progressive universalism is essential to achieve poverty alleviation strategies and reduce inequality for egalitarian development.

Trends in socioeconomic inequalities in breast cancer mortality in Canada: 1992-2019.

Breast cancer is the second leading cause of death from cancer among Canadian females. This study aimed to quantify and assess trends in education and income inequalities in the mortality rate of breast cancer in Canada from 1992 to 2019. We constructed a census division-level dataset pooled from the Canadian Vital Death Statistics Database (CVSD), the Canadian Census of the Population (CCP), and the National Household Survey (NHS) to examine trends in education and income inequalities in the mortality rate of breast cancer in Canada over the study period. The age-standardized Concentration index (C) was used to quantify income and education inequalities in breast cancer mortality over time. The national crude mortality rate of breast cancer has decreased in Canada from 1992 to 2019, with Alberta, British Columbia, Manitoba, Ontario, Prince Edward Island, and Quebec having the greatest decreases in mortality rate. The age-standardized C for education and income inequalities were always negative for all the study years, meaning that the mortality rate of breast cancer was higher among less-educated and poorer females. Moreover, the results indicate a growing trend in the concentration of breast cancer mortality among females with lower income and education from 1992 to 2019. The increasing concentration of breast cancer mortality among low socioeconomic status females remains a challenge in Canada. Continuous efforts are needed within Canadian healthcare systemto improve the prevention and treatment of breast cancer for this population.

Social inequality and residential segregation trends in Spanish global cities. A comparative analysis of Madrid, Barcelona, and Valencia (2001-2021)

Over the last three decades, the most populated Spanish cities have experienced significant spatial, social, and economic changes. The new urban economies have played an essential role in the acceleration of such transformations, entailing a range of both positive and negative impacts at the spatial, social, economic, and environmental levels. This paper presents a quantitative analysis of how the advancement of the globalization and deindustrialization processes has encouraged social polarization in the cities of Madrid, Barcelona, and Valencia, as well as a significant increase in intra-urban socioeconomic residential segregation. The article concludes by arguing that the increase in levels of social inequality and residential segregation reflects the trend towards polarized urban models, which reproduce in urban space the differences observed in the social structure.

Enabling the examination of long-term mortality trends by educational level for England and Wales in a time-consistent and internationally comparable manner

BackgroundStudying long-term trends in educational inequalities in health is important for monitoring and policy evaluation. Data issues regarding the allocation of people to educational groups hamper the study and international comparison of educational inequalities in mortality. For the UK, this has been acknowledged, but no satisfactory solution has been proposed.ObjectiveTo enable the examination of long-term mortality trends by educational level for England and Wales (E&W) in a time-consistent and internationally comparable manner, we propose and implement an approach to deal with the data issues regarding mortality data by educational level.MethodsWe employed 10-year follow-ups of individuals aged 20+ from the Office for National Statistics Longitudinal Study (ONS-LS), which include education information from each decennial census (1971–2011) linked to individual death records, for a 1% representative sample of the E&W population. We assigned the individual cohort data to single ages and calendar years, and subsequently obtained aggregate all-cause mortality data by education, sex, age (30+), and year (1972–2017). Our data adjustment approach optimised the available education information at the individual level, and adjusts—at the aggregate level—for trend discontinuities related to the identified data issues, and for differences with country-level mortality data for the total population.ResultsThe approach resulted in (1) a time-consistent and internationally comparable categorisation of educational attainment into the low, middle, and high educated; (2) the adjustment of identified data-quality related discontinuities in the trends over time in the share of personyears and deaths by educational level, and in the crude and the age-standardised death rate by and across educational levels; (3) complete mortality data by education for ONS-LS members aged 30+ in 1972–2017 which aligns with country-level mortality data for the total population; and (4) the estimation of inequality measures using established methods. For those aged 30+ , both absolute and relative educational inequalities in mortality first increased and subsequently decreased.ConclusionWe obtained additional insights into long-term trends in educational inequalities in mortality in E&W, and illustrated the potential effects of different data issues. We recommend the use of (part of) the proposed approach in other contexts.

Analytical utility of periodizing capitalist history: Neoliberalism, social welfare spending, and income inequality in the United States

This article critiques policies aimed at income redistribution within the framework of Marx’s critique of political economy. The ‘Neoliberal’ characterization of capitalist history, the tendency to divide capitalism into distinct sub-periods or phases, continues to play a significant role for describing changes to social policy in the United States. Prominent academics and public intellectuals continue to hold spirited debates over whether or not welfare spending in the United States has become less generous over the years, owing to increasing ‘neoliberalization’ of the American economy. This mixed-methods research paper analyzes trends in social welfare spending and income inequality for the United States. To supplement the analysis, a novel dataset on Distributional National Accounts from the Bureau of Economic Analysis is also analyzed. Evidence suggests previous concerns in the literature are unfounded and are not borne out by empirical evidence.

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.

Inequality in history: A long‐run view

AbstractThis article provides an overview of long‐term trends in income and wealth inequality, from ca. 1300 until today. It discusses recent acquisitions in terms of inequality measurement, building upon earlier research and systematically connecting preindustrial, industrial, and post‐industrial tendencies. It shows that in the last seven centuries or so, inequality of both income and wealth has tended to grow continuously, with two exceptions: the century or so following the Black Death pandemic of 1347–52, and the period from the beginning of World War I until the mid‐1970s. It discusses recent encompassing hypotheses about the factors leading to long‐run inequality change, highlighting their relative merits and faults, and arguing for the need to pay close attention to the historical context.

Inequality and social stratification in Russia during the Putin regime: From market transition to war on Ukraine

AbstractThe collapse of the USSR in late 1991 inspired social science research on levels, patterns, and trends in inequality within Russia, due to theoretical interest in how market transition affects social stratification. The start of the Putin regime in 2000 marked a new era in Russia's post‐Soviet political economic trajectory: in contrast to the 1990s, the economy first took off, then stagnated, while the state rolled back institutions of democracy and civic freedoms. In short, Russia became a consolidated market economy under authoritarian rule. In this context research has continued to produce insights into social stratification. The labor market featured high levels of employment but with downward wage flexibility, modest decreases in earnings inequality, and persistent returns to education, gender wage gaps, and locality‐based differences. Waves of labor migration to Russia, resurgent traditional gender norms, shrinking population, housing inequality, health disparities, and a small contingent of ultra‐rich represent additional noteworthy developments. Although market transition is no longer an intriguing theoretical lens through which to view social stratification in Russia, the topic nonetheless holds broader theoretical interest because inequality became closely intertwined with Russia's political economy, social policies, and geopolitical actions, including those that culminated in Putin's decision to invade Ukraine.

Trends in health inequalities in childhood and adolescence in Germany: Results of the HBSC study 2009/10 - 2022.

Many studies have identified health inequalities in childhood and adolescence. However, it is unclear how these have developed in recent years, particularly since the COVID-19 pandemic. Analyses are based on the German data from the international Health Behaviour in School-aged Children (HBSC) study from 2009/10 (n = 5,005), 2013/14 (n = 5,961), 2017/18 (n = 4,347), and 2022 (n = 6,475). A total of 21,788 students aged approximately between 11 and 15 years were included. Socioeconomic status (SES) was assessed using the Family Affluence Scale (FAS). Several health indicators were analysed stratified by gender using bivariate and multivariate analysis methods. In 2022, there are clear socioeconomic inequalities in life satisfaction, self-rated health, fruit and vegetable consumption, and physical activity. These inequalities remained largely constant or increased between 2009/10 and 2022. Between 2017/18 and 2022, no significant changes in inequalities were found. Health inequalities are persistent and reduce the chances of growing up healthy. There is no evidence that inequalities in the analysed outcomes have changed during the pandemic period (between 2017/18 and 2022). Rather, the changes in the health indicators seem to affect all adolescents in a similar way.

Access of Urban Poor to Basic Services: Concerns of Sustainability and Equity

Sharp inequality in India’s urban economy, coupled with an increasing reliance on the market system for infrastructure and basic services, has led to inadequate access to and poor quality of amenities for the urban poor. Disparities in welfarist interventions by central and state governments, manifest in changing administrative paradigm, have impacted inequality trends and patterns. Given this macro scenario, this article is designed to achieve two objectives: one, an analysis of the differential access of urban poor to select basic amenities and changes therein over time at the national level. An attempt is also made to bring out the deficits in amenities for households in different asset quintiles within the framework of India’s inclusive development strategy. Two, to analyse the pattern of access to basic services across the states, their changing pattern over time, and probe into their interdependencies with indicators of environmental sustainability. The basic idea is to examine quantitatively the complex relationship between the utilisation of natural resources, environmental degradation, and the provisioning of basic amenities to the poor. The possibility of the poor being forced to use non-renewable resources, posing serious threats to their micro-environment and its long-term implications are discussed using available secondary data and over-viewing empirical research on the subject. The article concludes by proposing broad directions in which solutions to the twin problems of providing a decent living environment to the poor and ensuring ecological sustainability can be sought.

Socio-Economic-Driven Disparities in Chronic Illness and Disability Among the South African Children: Exploring Variations Within the Urban and Rural Areas

ABSTRACT: Existing literature on health inequalities often overlooks the nuanced dynamics, particularly among vulnerable children with chronic diseases and disabilities and fails to consider regional disparities within countries like South Africa. This paper asserts the necessity for a more granular analysis in South Africa, recognizing the varied health outcomes for children across different economic segments and geographical settings. Specifically, the health trajectories for children differ markedly between rural formal areas, regions under traditional authorities, formal urban areas, and informal urban settlements. Addressing the generalizations common in prior research, this study takes a precise, regionally focused approach to socio-economic-driven disparities in chronic illness or disability. It distinguishes between rural formal areas, traditional authority areas, formal urban areas, and informal urban areas, unveiling the intricate layers of health disparities. Using data from the National Income Dynamics Study, concentration indices, and the Oaxaca-Blinder Decomposition method, the paper analyzed health inequality trends from 2008 to 2017. The results uncover significant inequalities, with alarming trends, particularly among children with chronic illnesses and disabilities in traditional authority regions and informal urban environments. The paper's evidence shows that rural formal areas have experienced a decline in health disparities as opposed to the deepening divide in traditional authority-led regions. The urban analysis reveals a split: while formal urban settings often favour the wealthier, informal urban areas indicate a shift towards lower socioeconomic brackets. The decomposition analysis highlights the evolving socioeconomic elements influencing each region over time. These insights emphasize the urgent necessity for geographically tailored policy interventions. By understanding the distinct socioeconomic landscapes across various regions, we can formulate policies that resonate with each area's specific realities and challenges. Such targeted strategies are essential in reducing health inequalities and enhancing the life quality of children with chronic health conditions and disabilities, playing a critical role in South Africa's journey toward comprehensive health equity.

Income Inequality Trends in Central Uttar Pradesh Districts, India

Nearly six decades following independence, some parts of Uttar Pradesh remain extremely backward and are home to the majority of the nation's impoverished. The state has long suffered from regional inequities and inequality. Intraregional differences provide huge issues because of their compounding effects on governance and living circumstances. The Paper aims to study the growth performance and the convergence/divergence in growth among districts from 2011–12 to 2017–18 in Central Uttar Pradesh. Uttar Pradesh is divided into four regions: Western region, Central region, Bundelkhand region and Eastern region. The central region had been chosen for study through Cluster sampling technique. We used two Convergence measures: Beta convergence, which relies on neoclassical growth theory, and Sigma convergence, which uses the coefficient of variation to measure the spread of per capita net income. We found a negative relationship between the two variables in estimating a regression equation linking growth to the PCNI's initial per capita income log. Growth and starting per capita net income had a statistically insignificant negative association the whole time. The levels of PCNI (Per capita Net Income) depicts inter-district disparity decline as shown by the decreasing coefficient of variation. The study offers a policy suggestion that a comprehensive policy strategy that takes into account economic, social and infrastructural element is necessary.

The sources and structure of wage inequality changes in the selected Central-Eastern European Countries

AbstractWe study the determinants of wage inequality and its fluctuations in six Central-Eastern European nations using European Union Statistics on Income and Living Conditions microdata from 2010 to 2019. Wage disparity in these countries changed in distinct ways. Inequality in Czechia and Romania is generally steady, has fallen consistently in Poland and Slovakia, and has increased in Bulgaria. Inequality has been steadily reducing in Hungary but has recently increased significantly. Therefore, this paper questions these countries' primary causes of wage inequality changes. In addition to providing a detailed description of inequality trends in these countries, we focus on examining the demographic and micro-level determinants alongside the minimum wage changes. We estimate these effects using RIF regression and RIF decompositions for various inequality measures. The changes in wage inequality in these countries were driven mainly by wage structure effects regardless of the increase or decrease in wage inequality. Changes in the returns to education and returns to permanent employment contracts are crucial in explaining decreased wage inequality. The increases in wage inequality in Hungary and Bulgaria are defined mainly by the changes in the estimated constants instead of micro-level determinants. The changes in the minimum wage explain most of the unknown factors in Bulgaria, and the spillover effects of the minimum wage may explain most of the unknown factors in Hungary. Our results can support the skill-biased technological change hypothesis in the case of Slovakia, Romania, Czechia, and Bulgaria.