Welfare Inequality Research Articles

The Lancet Commission on Gender and Global Health

Gender inequalities drive inequities in health and wellbeing. From determining our chance of being born1 to the predominantly male-led delivery of our funerals,2,3 gender interacts with, and frequently amplifies, other inequalities such as race or poverty in shaping our entire life experience. The global goal of equality on the basis of gender is an integral part of other global struggles for inclusive, rights-based, respectful, equitable systems, structures, and communities.

Cuts both ways: Ethnicity, poverty, and the social gradient in child welfare interventions

This article presents the findings of a quantitative intersectional analysis of child welfare interventions within small area ethnic populations in England. Recent research has highlighted that White British children, on average, have higher rates of intervention than children from other ethnic groups in poorer neighbourhoods and lower rates in more affluent neighbourhoods. This raises the question of whether structural associations between poverty and child welfare interventions apply equally to children from all backgrounds, or whether recent research into socioeconomic child welfare inequalities is largely capturing differences between ethnic groups. We investigate this question using multilevel negative binomial regression models predicting rates of children in need, children on child protection plans, and children in State care in ethnic group populations within geographical areas with average populations of 7200 children and adults. We find significant differences in ethnic group intervention rates, depending on levels of deprivation. Available data have significant limitations, but intersectional analysis identifies that a social gradient does not apply to, or is much smaller for, many ethnic populations and is strongest for White and Mixed Heritage populations. Socioeconomic inequalities in child protection are highly contingent on the ethnicity of the population, reflecting broader sociological literature related to race and class. This limits the generalisability of non-intersectional child welfare inequalities and introduces new avenues and imperatives for research seeking to better understand both ethnic and socioeconomic inequalities in children’s social services. We consider that, beyond institutional racism, social work may need to grapple with complex forms of ‘institutionalised intersectional injustice’.

On the Unique Justifying Functions of Mind Ethic Ideology

Considerable research and theory have pointed to the system-justifying function of Meritocratic Ideology (i.e., the belief that hard work leads to success), noting how useful it can be in justifying inequalities in material well-being (e.g., wealth). We propose that a distinct form of ideology, which we term “Mind Ethic,” has emerged to help people justify inequalities by advocating proper mental habit (e.g., thinking properly about the relevant desire) as a useful tool for goal achievement. Across four studies, we devise a measure to capture individual differences in Mind Ethic, and then demonstrate its unique predictive power. Studies 1a and 1b demonstrate that whereas both Meritocratic Ideology and Mind Ethic predict character derogation (vs. enhancement) of those who suffer (vs. those who are succeeding) in contexts of material well-being (e.g., attributing higher intelligence to a rich person), only Mind Ethic predicts such system-justifying tendencies in contexts of psychological well-being (e.g., attributing increased laziness to those who are unhappy). Studies 2 and 3 further examine Mind Ethic’s system-justifying function across two different domains (i.e., career and health) and show that Mind Ethic predicts justification of target persons’ unequal life outcomes when those are attributed to differences in the targets’ mental habits or mental effort (i.e., having negative thoughts vs. having positive thoughts in Study 2, only receiving radiation therapy vs. receiving additional meditation in Study 3), but not when the outcomes are attributed to differences in what the targets do about the relevant goals (i.e., not working hard vs. working hard in Study 2, only receiving radiation therapy vs. receiving additional chemotherapy in Study 3). This research suggests that Mind Ethic may provide a unique set of rationale for justification of unequal outcomes.

Old-Age Inequality with Longevity Extension from Preventive Healthcare

We analyze whether endogenizing preventive healthcare investment in the lifetime portfolio affects the utility inequality of the elderly. To assess inequality, we exploited the coefficient of variation of the value function for the representative agent. Comparing the inequality of two simple cases with or without a choice of preventive cost reveals how the optimal choice of healthcare prevention affects inequality. The longevity extension from optimal prevention increases both inter- and intra-country welfare inequality among the elderly, mainly due to the adjusted pricing of financial assets. Calibrated results show that prevention endogenization increases the coefficient of variations by 6.9% for 24 OECD countries and by 3.9% for the elderly in the US.

Integrated sports and respiratory medicine in the aftermath of COVID-19

COVID-19 has revealed inequalities in health, wellbeing, and economic status across communities and has exposed vulnerabilities in societal groups. While the pressure of the first peak abates, there is an urgent need to consider the long-term care needs of those affected by COVID-19 to ensure that it does not widen inequality. At the time of writing, the long-term effects on recovering patients remains unknown. Research on Severe Acute Respiratory Syndrome coronavirus (SARS) and Middle Eastern Respiratory Syndrome coronavirus (MERS) infection are associated with persisting abnormal radiographic change, substantial impairment of exercise and functional capacity, and reduced quality of life following Acute Respiratory Distress Syndrome (ARDS).

Identifying and capitalizing new sources of competitive advantages is a vital prerequisite for corporate sustainability

Abstract On both the research agendas of the specialists in the academic field and those of the decision makers in the field of public policies, there are a series of topics of reflection among the most provocative which calls on researchers to identify solutions to new challenges. These include the prevalence of topics such as: threats to climate balance, deepening inequalities in welfare and prosperity, paradigm shifts in management and leadership, the emergence of on demand economy, just transition or the new scale of competitive advantages. At the microeconomic level, one of the most complex issues is that of business sustainability, which, under the conditions of the new global economic picture, must be equally efficient, economically, sustainable, socially, and resilient from an ecological point of view. Despite the most renowned experts analyzing the concept of competitive advantage, having highlighted the epistemological and praxiological foundations and clarified the variables on which its scope depends, the regional and global economic picture in dynamic change makes the analytical space continue. for this thematic area. This paper starts from the methodological assumption that the decision makers at the level of the companies must ensure the possible but synergistic combination between: the objective of maximizing the profit and the one of taking into account the plenary of maximizing the sales or of extending the relational capital. The main purpose of this paper is to study the deepest changes at the microeconomic level of the competitive advantage scale, the factors that influence these changes and propose a series of ways by which the companies that operate in Romania can be repositioned sustainably at the level of the most powerful regional supply chains.

Health and fairness with other-regarding preferences

This paper explores how to rank social allocations when individuals have other-regarding preferences (ORPs). Unlike the few existing studies on this issue, we focus on two different private goods, only one of which generates ORPs concerns. Specifically, individuals exhibit other-regarding views about the social health state but have standard self-centered preferences over other goods, namely consumption. Our social evaluation also incorporates a fairness view that aims to reduce inequalities that originate from factors for which individuals should not be deemed responsible. By resorting to a non-resourcist approach, we derive social preferences that seek to reduce individual well-being inequalities. Such differences are assessed by means of an interpersonal comparable measure that is related to an ideal situation which involves neither externalities nor unfair inequalities. We obtain that the use of the state of perfect health as the reference value leads society to give a higher priority to those who exhibit more altruistic preferences.

Planning for environmental justice - reducing well-being inequalities through urban greening

Urban green spaces provide cultural ecosystem services, and urban policies typically aim to enhance these services by targeting new investments in deprived areas. The implementation of urban greening policies is one way to reduce inequalities in well-being, for example by targeting areas where increased access to green spaces will benefit citizens of low socioeconomic status. Most research has addressed the targeting of green infrastructure development by considering income and access to green spaces, while few studies have considered a multidimensional definition of well-being. The aims of this paper are to i) integrate inputs from the economic and political philosophy literature to propose a broader definition of well-being, including health, education, insecurity, and social relations; ii) develop a criterion to prioritise areas where urban greening would have the greatest impact on well-being inequalities; and iii) apply this criterion to the Paris metropolitan area (Ile-de-France region), a spatially heterogeneous region where areas deprived of access to green spaces are not systematically deprived in other dimensions. Our analysis shows that the city of Paris and the inner suburbs would be targeted when considering inequality in access to green spaces only. The results differ when inequalities in income or multidimensional well-being are taken into account, in which case the northern inner suburbs and some outer suburbs become a higher priority.

National-Level Wealth Inequality and Socioeconomic Inequality in Adolescent Mental Well-Being: A Time Series Analysis of 17 Countries

PurposeAlthough previous research has established a positive association between national income inequality and socioeconomic inequalities in adolescent health, very little is known about the extent to which national-level wealth inequalities (i.e., accumulated financial resources) are associated with these inequalities in health. Therefore, this study examined the association between national wealth inequality and income inequality and socioeconomic inequality in adolescents' mental well-being at the aggregated level. MethodsData were from 17 countries participating in three consecutive waves (2010, 2014, and 2018) of the cross-sectional Health Behaviour in School-aged Children study. We aggregated data on adolescents' life satisfaction, psychological and somatic symptoms, and socioeconomic status (SES) to produce a country-level slope index of inequality and combined it with country-level data on income inequality and wealth inequality (n = 244,771). Time series analyses were performed on a pooled sample of 48 country-year groups. ResultsHigher levels of national wealth inequality were associated with fewer average psychological and somatic symptoms, while higher levels of national income inequality were associated with more psychological and somatic symptoms. No associations between either national wealth inequality or income inequality and life satisfaction were found. Smaller differences in somatic symptoms between higher and lower SES groups were found in countries with higher levels of national wealth inequality. In contrast, larger differences in psychological symptoms and life satisfaction (but not somatic symptoms) between higher and lower SES groups were found in countries with higher levels of national income inequality. ConclusionsAlthough both national wealth and income inequality are associated with socioeconomic inequalities in adolescent mental well-being at the aggregated level, associations are in opposite directions. Social policies aimed at a redistribution of income resources at the national level could decrease socioeconomic inequalities in adolescent mental well-being while further research is warranted to gain a better understanding of the role of national wealth inequality in socioeconomic inequalities in adolescent health.

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.

Intersectionality and Adolescent Mental Well-being: A Cross-Nationally Comparative Analysis of the Interplay Between Immigration Background, Socioeconomic Status and Gender

PurposeIntersectionality theory highlights the importance of the interplay of multiple social group memberships in shaping individual mental well-being. This article investigates elements of adolescent mental well-being (life dissatisfaction and psychosomatic complaints) from an intersectional perspective. It tests mental well-being consequences of membership in combinations of multiple social groups and examines to what extent such intersectional effects depend on the national context (immigration and integration policies, national-level income, and gender equality). MethodsUsing Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy, we assessed the role of the national context in shaping the interplay between immigration background, socioeconomic status, and gender, using data from 33 countries from the 2017/2018 Health Behaviour in School-aged Children survey. ResultsWe found no uniform intersectionality effects across all countries. However, when allowing the interplay to vary by national context, results did point toward some intersectional effects. Some aggravated negative effects were found for members of multiple disadvantaged social groups in countries with low levels of income equality and restrictive migration policies, whereas enhanced positive effects were found for members of multiple advantaged groups in these countries. Similarly, mitigated negative effects of membership in multiple disadvantaged groups were shown in countries with higher levels of income equality and more inclusive migration policies, whereas mitigated positive effects were found for multiply advantaged individuals. Although for national-level gender equality results pointed in a similar direction, girls' scores were counterintuitive. High national-level gender equality disproportionately benefitted groups of disadvantaged boys, whereas advantaged girls were doing worse than expected, and reversed effects were found for countries with low gender equality. ConclusionsTo fully understand social inequalities in adolescent mental well-being, the interplay between individual-level and national-level indicators must be explored.

The Buffering Effects of Social Capital on Inequalities in Subjective Well-Being Among Older People

Empirical evidence regarding the buffering effects of community social capital on health inequality is limited. This study aims to examine the moderating effects of a community’s social capital on socioeconomic inequalities in subjective well-being (life satisfaction) among older people. Using cross-sectional data from Seoul, South Korea, 5000 older people (65 years old or older) were analyzed. Cognitive social capital was operationalized as the average level of generalized and public trust, and structural social capital was measured by the average group membership per capita. As social capital has been found to function in beneficial ways by promoting social interactions, norms and resources, it was hypothesized that it would reduce the socioeconomic gradients of life satisfaction. Multilevel models were applied to examine the contextual and cross-level interaction effects. The results showed that socioeconomic inequalities in life satisfaction among older people do exist. Some moderating effects of community social capital were also found. Generalized trust at the community level decreased the association between education and life satisfaction (B = − .472, p < .001). In addition, the average level of public trust in the community also moderated the association between education and life satisfaction (B = − .653, p < .05). The results of this study expand previous findings on the beneficial effects of social capital: Community social capital not only improves the health of individuals but also reduces the level of inequalities in health.

A multidimensional approach to the well-being of the population of the states of Mexico

This article adapts a multidimensional index of the well-being of the population in the Mexican States, based on the recommendations of the Commission on the Measurement of Economic Performance and Social Progress (CMEPSP). This study&apos;s contributions can be summarized in three key points: (i) factor analysis of principal components is used, to allow for different weights of dimensions; (ii) consideration is given to inequality of material well-being within the population of each state, and; (iii) representative state data are considered for all dimensions. The results show that the dimensions of objective well-being have greater weights than the dimensions of subjective well-being, and that differences between weights of dimensions and indicators used are more important than their quantity or characteristics.

Multidimensional Inequality in Vietnam, 2002–2012

We investigate the evolution of multidimensional inequality of well-being in Vietnam in the period 2002–2012 using household survey data. Our study focuses on four crucial dimensions of human welfare: consumption, education, health and housing. We measure inequality by means of the multidimensional Atkinson index, which belongs to the Atkinson family of relative inequality indices. The choice of the values of two crucial parameters, with respect to the aversion to inequality on the one hand and the degree of substitutability between dimensions on the other hand, has a significant influence on the perceived trends of inequality. We consider different combinations of dimensions (two, three and four dimensions) and a wide variety of values of the parameters, with the aim of arriving at a robust understanding of the extent of inequality in Vietnam. Our results suggest that the level of multidimensional inequality in Vietnam has decreased, albeit that this is not the case for all combinations of the parameter values. Our study shows that looking at multidimensional rather than one-dimensional inequality leads to a richer understanding of the evolution of inequality, and indicates that it is important to be aware of the influence of value judgments on the assessment of inequality.

Estructuras de los arreglos residenciales y desigualdades en México

El objetivo de este trabajo es indagar si el tipo de arreglo residencial familiar influye en la calidad de vida de sus integrantes, aspecto que se ve reflejado en desigualdades en el bienestar socioeco-nómico, desigualdades de género en el ejercicio del poder y desigualdades según el grado de ur-banización del lugar de residencia. La fuente de datos empleada es la Encuesta Intercensal 2015. La clasificación de los arreglos está basada en Laslett y Wall (1972) que permite distinguir entre arreglos simples y múltiples. Para el análisis, se construyó un índice de bienestar y se aplicaron modelos de regresión logística binarios. Los principales resultados son los siguientes. El tipo de arreglo residencial más ventajoso en términos del bienestar socioeconómico de sus miembros es el nuclear, mientras que, en el caso del arreglo monoparental, depende de su composición. En ge-neral, la figura de “jefe” del arreglo residencial asignada por sus integrantes, atribuye con mucha frecuencia a los hombres esta característica; esta situación varía según el tipo de arreglo. En la Ciudad de México, contexto altamente urbanizado, los arreglos nucleares son menos frecuentes, el clima educativo es más alto y la jefatura femenina más usual.

Reproductive health, fairness, and optimal policies

AbstractWe consider an overlapping generations economy in which agents differ through their ability to procreate. Ex‐ante infertile households may incur health expenditure to increase their chances of parenthood. This health heterogeneity generates welfare inequalities that deserve to be ruled out. We explore three different criteria of social evaluation in the long‐run: the utilitarian approach, the ex‐ante egalitarian criterion and the ex‐post egalitarian one. We propose a set of economic instruments to decentralize each solution. To correct for the externalities and health inequalities, both a preventive (a taxation of capital) and a redistributive policy are required. We show that a more egalitarian allocation is associated with higher productive investment but reduced health expenditure and thus, lower population growth.

Socio-Economic Inequality of Wellbeing: A Comparison of Switzerland and South Africa

The study seeks answers to the broader question on the income-wellbeing nexus through a seldom utilised technique of concentration index to measure income related wellbeing inequality. The analysis is undertaken in the vastly differing income and income inequality contexts of Switzerland and South Africa to contrast the relationships in different scenarios over a 10-year period. The study brings forth the findings that wellbeing is concentrated among the higher end of the income distribution in both countries but that the level of wellbeing concentration is lower in Switzerland as compared to South Africa. The Oaxaca–Blinder decomposition of the Erreygers-corrected concentration index indicates that the differences in the wellbeing concentration levels of the two countries are due to both the difference in the levels of income as well as the differences in the marginal utility of income in the two countries. Results indicate that South Africa’s pro-rich concentration of wellbeing would decrease substantially with Swiss endowments. On the other hand, income based concentration of wellbeing would increase in South Africa with Swiss coefficients. The differences in the coefficients of absolute and relative income, contribute more to the differences in wellbeing concentration in the two countries than the levels of these variables. This indicates that the level of income and relative income is important in understanding the impact of these variables on wellbeing inequality. Further, the decomposition analysis of the concentration index for each country to understand the relative importance of variables indicates that while relative income is a significant driver of wellbeing inequality in South Africa and Switzerland, its importance is lower than absolute income in determining the concentration of wellbeing.

Análisis multidimensional de la desigualdad en el marco del desarrollo humano

En este trabajo se trata de contribuir al estudio de la desigualdad en el bienestar, concebido como un proceso multidimensional, analizando la desigualdad entre países en términos del Índice de Desarrollo Humano (IDH). El estudio se aborda a partir de dos enfoques metodológicos alternativos basados en los índices de entropía generalizada. Nuestros resultados ponen de manifiesto que, tanto en las tres dimensiones del desarrollo como en indicadores compuestos de estas componentes, se ha producido una disminución de la desigualdad a nivel mundial en el periodo 1980-2011. La descomposición de estas medidas en los componentes interregional e intrarregional revelan que la disminución de la desigualdad en el bienestar es debida principalmente a la disminución de la desigualdad entre regiones.

Endogenous Selection Bias and Cumulative Inequality over the Life Course: Evidence from Educational Inequality in Subjective Well-Being

Abstract According to theories of cumulative (dis-)advantage, inequality increases over the life course. Labour market research has seized this argument to explain the increasing economic inequality as people age. However, evidence for cumulative (dis-)advantage in subjective well-being remains ambiguous, and a prominent study from the United States has reported contradictory results. Here, we reconcile research on inequality in subjective well-being with theories of cumulative (dis-)advantage. We argue that the age-specific endogenous selection of the (survey) population results in decreasing inequalities in subjective well-being means whereas individual-level changes show a pattern of cumulative (dis-)advantage. Using repeated cross-sectional data from the European Social Survey (N = 15,252) and employing hierarchical age-period-cohort models, we replicate the finding of decreasing inequality from the United States with the same research design for Germany. Using panel data from the German Socio-Economic Panel Study (persons = 47,683, person-years = 360,306) and employing growth curve models, we show that this pattern of decreasing inequality in subjective well-being means is accompanied by increasing inequality in intra-individual subjective well-being changes. This pattern arises because disadvantaged groups, such as the low educated and individuals with low subjective well-being show lower probabilities of continuing to participate in a survey and because both determinants reinforce each other. In addition to allowing individual changes and attrition processes to be examined, the employed multi-cohort panel data have further key advantages for examining inequality in subjective well-being over the life course: They require weaker assumptions to control for period and cohort effects and make it possible to control for interviewer effects that may influence the results.

Untangling child welfare inequalities and the ‘Inverse Intervention Law’ in England

This article addresses some potential limitations of key findings from recent research into inequalities in children’s social services by providing additional evidence from multilevel models that suggest the socioeconomic social gradient and ‘Inverse Intervention Law’ in children’s services interventions are statistically significant after controlling for possible confounding spatial and population effects. Multilevel negative binomial regression models are presented using English child welfare data to predict the following intervention rates at lower super output area-level: Child in Need (n = 2707, middle super output area [MSOA] n = 543, local authority [LA] n = 13); Child Protection Plan (n = 4115, MSOA n = 837, LA n = 18); and Children Looked After (n = 4115, MSOA n = 837, LA n = 18). We find strong evidence supporting the existence of a steep socioeconomic social gradient in child welfare interventions. Furthermore, we find certain local authority contexts exacerbate this social gradient. Contexts of low overall deprivation and high income inequality are associated with greater socioeconomic inequalities in neighbourhood intervention rates. The relationship between neighbourhood deprivation and children looked after rates is almost five times stronger in local authorities with these characteristics than it is in local authorities with high overall deprivation and low income inequality. We argue that social policy responses addressing structural determinants of child welfare inequalities are needed, and that strategies to reduce the numbers of children taken into care must address underlying poverty and income inequality at both a local and national level.