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1
Stephens, Carolyn. "Healthy Cities or Unhealthy Islands? The Health and Social Implications of Urban Inequality." Urbanisation 3, no. 2 (October 23, 2018): 108–30. http://dx.doi.org/10.1177/2455747118805840.
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This paper suggests that governments and international agencies must address the large and often growing levels of inequality within most cities if health is to be improved and poverty reduced. It describes the social and health implications of inequalities within cities and discusses why descriptions of the physical symptoms of poverty (and their health implications) are more common than analyses of the structural systems which produce and perpetuate poverty. It also describes the health problems from which low-income groups in urban areas suffer more than richer groups including those that are not linked to poor sanitary conditions and those that are more linked to relative poverty (and thus the level of inequality) than to absolute poverty.
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Nelson, Michael. "Childhood nutrition and poverty." Proceedings of the Nutrition Society 59, no. 2 (May 2000): 307–15. http://dx.doi.org/10.1017/s0029665100000343.
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One in three children in Britain lives in poverty (households whose income was less than 50 % average earnings). Low income is associated with poor nutrition at all stages of life, from lower rates of breast-feeding to higher intakes of saturated fatty acids and lower intakes of antioxidant nutrients. Moreover, there is increasing evidence that poor nutrition in childhood is associated with both short-term and long-term adverse consequences such as poorer immune status, higher caries rates and poorer cognitive function and learning ability. These problems arise primarily because parents do not have enough money to spend on food, not because money is being spent unwisely. Policy options to improve the dietary health of poor children include: giving more money to the parents by increasing Income Support (social security) payments, providing food stamps or vouchers, and using food budget standards to inform the levels of income needed to purchase an adequate diet; feeding children directly at school (not only at lunchtime but also at breakfast or homework clubs), by providing free fruit at school, and by increasing entitlement to free food amongst children living in households with low incomes; improving access to a healthy and affordable diet by first identifying ‘food deserts’ and then considering with retailers and local planners how best to provide food in an economical and sustainable way. The value of using food budget standards is illustrated with data relating expenditure on food to growth in children from ‘at-risk’ families (on low income, overcrowded, headed by a lone parent or with four or more children under 16 years of age) living in a poor area in London. Lower levels of expenditure are strongly associated with poorer growth and health, independent of factors such as birth weight, mother’s height, or risk score. The present paper provides evidence that supports the need to review Government legislation in light of nutrition-related inequalities in the health of children.
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Shackleton, Nichola. "Is there a link between low parental income and childhood obesity?" Journal of Early Childhood Research 15, no. 3 (October 28, 2015): 238–55. http://dx.doi.org/10.1177/1476718x15606479.
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The association between familial socioeconomic status and child obesity has created the expectation that low familial income increases the risk of child obesity. Yet, there is very little evidence in the United Kingdom to suggest that this is the case. This article focuses on whether low familial income and family poverty are associated with an increased risk of child obesity. Data from the Millennium Cohort Study (age 7) are analysed. Sequential logistic regression analyses are used to determine whether income has a direct link to childhood weight. The results show no direct relationship between familial income/poverty and weight in childhood. Numerous robustness checks provide considerable evidence that low familial income has no association with children’s weight status in the United Kingdom. The results demonstrate that social inequalities in child weight are not driven by differences in income.
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Lu, Chunling, Jorge Cuartas, Günther Fink, Dana McCoy, Kai Liu, Zhihui Li, Bernadette Daelmans, and Linda Richter. "Inequalities in early childhood care and development in low/middle-income countries: 2010–2018." BMJ Global Health 5, no. 2 (February 2020): e002314. http://dx.doi.org/10.1136/bmjgh-2020-002314.
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BackgroundInequalities in early childhood development (ECD) tend to persist into adulthood and amplify across the life course. To date, little research on inequalities in early childhood care and development in low/middle-income countries has been available to guide governments, donors and civil society in identifying which young children and families should be targeted by policies and programmes to improve nurturing care that could prevent them from being left behind.MethodsUsing data from 135 Demographic and Health Surveys and Multiple Indicator Cluster Surveys between 2010 and 2018, we assessed levels and trends of inequalities in exposure to risks of stunting or extreme poverty (under age 5; levels in 85 and trends in 40 countries), early attendance of early care and education programmes (36–59 months; 65 and 17 countries), home stimulation (36–59 months; 62 and 14 countries) and child development according to the Early Childhood Development Index (36–59 months; 60 and 13 countries). Inequalities within countries were measured as the absolute gap in three domains—child gender, household wealth and residential area—and compared across regions and country income groups.Results63% of children were not exposed to stunting or extreme poverty; 39% of 3–4-year olds attended early care and education; and 69% received a level of reported home stimulation defined as adequate. Sub-Saharan Africa had the lowest proportion of children not exposed to stunting or extreme poverty (45%), attending early care and education (24%) and receiving adequate home stimulation (47%). Substantial gaps in all indicators were found across country income groups, residential areas and household wealth categories. There were no significant reductions in gaps over time for a subset of countries with available data in two survey rounds.ConclusionsAvailable data indicate large inequalities in early experiences and outcomes. Efforts of reducing these inequalities must focus on the poorest families and those living in rural areas in the poorest countries. Improving and applying population-level measurements on ECD in more countries over time are important for ensuring equal opportunities for young children globally.
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Rossouw, Laura, and Hana Ross. "Understanding Period Poverty: Socio-Economic Inequalities in Menstrual Hygiene Management in Eight Low- and Middle-Income Countries." International Journal of Environmental Research and Public Health 18, no. 5 (March 4, 2021): 2571. http://dx.doi.org/10.3390/ijerph18052571.
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Menstrual hygiene management and health is increasingly gaining policy importance in a bid to promote dignity, gender equality and reproductive health. Effective and adequate menstrual hygiene management requires women and girls to have access to their menstrual health materials and products of choice, but also extends into having private, clean and safe spaces for using these materials. The paper provides empirical evidence of the inequality in menstrual hygiene management in Kinshasa (DRC), Ethiopia, Ghana, Kenya, Rajasthan (India), Indonesia, Nigeria and Uganda using concentration indices and decomposition methods. There is consistent evidence of wealth-related inequality in the conditions of menstrual hygiene management spaces as well as access to sanitary pads across all countries. Wealth, education, the rural-urban divide and infrastructural limitations of the household are major contributors to these inequalities. While wealth is identified as one of the key drivers of unequal access to menstrual hygiene management, other socio-economic, environmental and household factors require urgent policy attention. This specifically includes the lack of safe MHM spaces which threaten the health and dignity of women and girls.
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Anderson, Annie S. "Nutrition interventions in women in low-income groups in the UK." Proceedings of the Nutrition Society 66, no. 1 (February 2007): 25–32. http://dx.doi.org/10.1017/s0029665107005265.
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In the UK the mental and physical health and well-being of millions of women are influenced by living in poverty. Low educational attainment, unemployment, low pay and poor areas of residence exacerbate the challenges of obtaining optimal food choices, dietary intake and healthy eating patterns. Poorer women are more likely to eat low amounts of fruits and vegetables, whole grains and fish, and higher amounts of sugar and sweetened drinks compared with more affluent women. Diet contributes to the health inequalities evident in high rates of diet-related morbidity (including obesity) and mortality (including IHD and stroke) and in maternal and child health considerations (including breast-feeding and family diet practices). There is a dearth of research on effective interventions undertaken with low-income women, reflecting some of the challenges of engaging and evaluating programmes with this ‘hard to reach’ subpopulation. Intervention programmes from the USA, including WISEWOMAN, the Women's Health Initiative, the American Special Supplemental Food Program for Women, Infants and Children and the Expanded Food and Nutrition Education Program provide models for changing behaviour amongst women in the UK, although overall effects of such programmes are fairly modest. Lack of evidence does not mean that that policy work should be not be undertaken, but it is essential that policy work should be evaluated for its ability to engage with target groups as well as for the behavioural change and health outcomes.
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Assari, Shervin. "Neighborhood Poverty and Amygdala Response to Negative Face." Journal of Economics and Public Finance 6, no. 4 (November 26, 2020): p67. http://dx.doi.org/10.22158/jepf.v6n4p67.
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Introduction: Considerable research has established a link between socioeconomic status (SES) and brain function. While studies have shown a link between poverty status and amygdala response to negative stimuli, a paucity of knowledge exists on whether neighborhood poverty is also independently associated with amygdala hyperactive response to negative stimuli. Purpose: Using functional brain imaging data, this study tested the association between neighborhood SES and the amygdala’s response to negative stimuli. Considering race as a sociological rather than a biological construct, we also explored racial heterogeneity in this association between non-Hispanic Black and non-Hispanic White youth. Methods: We borrowed the functional Magnetic Resonance Imaging (fMRI) data of the Adolescent Brain Cognitive Development (ABCD) study. The sample was 2,490 nine to ten years old non-Hispanic Black and non-Hispanic White adolescents. The independent variable was neighborhood income which was treated as a continuous measure. The primary outcomes were the right and left amygdala response to negative face during an N-Back task. Age, sex, race, marital status, and family SES were the covariates. To analyze the data, we used linear regression models. Results: Low neighborhood income was independently associated with a higher level of amygdala response to negative face. Similar results were seen for the right and left amygdala. These effects were significant net of race, age, sex, marital status, and family SES. An association between low neighborhood SES and higher left but not right amygdala response to negative face could be observed for non-Hispanic Black youth. No association between neighborhood SES and left or right amygdala response to negative face could be observed for non-Hispanic White youth. Conclusions: For American youth, particularly non-Hispanic Black youth, living in a poor neighborhood predicts the left amygdala reaction to negative face. This result suggested that Black youth who live in poor neighborhoods are at a high risk of poor emotion regulation. This finding has implications for policy making to reduce inequalities in undesired behavioral and emotional outcomes. Policy solutions to health inequalities should address inequalities in neighborhood SES.
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Schmeer, Kammi K., and Aimee Yoon. "Socioeconomic status inequalities in low-grade inflammation during childhood." Archives of Disease in Childhood 101, no. 11 (July 1, 2016): 1043–47. http://dx.doi.org/10.1136/archdischild-2016-310837.
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BackgroundFamily socioeconomic status (SES) is an important source of child health disparities in the USA. Chronic stress is one way SES may impact children's physiology with implications for later health inequalities. These processes may work differently across childhood due to differences in exposure and susceptibility to stressors at different ages. We assess associations between family SES and one biomarker of chronic stress exposure—low-grade inflammation detected by elevated C reactive protein (CRP)—and evaluate differences in the associations by child age.MethodsWe used nationally representative data from the National Health and Nutrition Examination Survey and Tobit regression models to estimate SES associations with CRP and the moderating effects of age for children age 2–18 years. Our sample was limited to CRP ≤10 mg/l to focus on low-grade inflammation (N=13 165).ResultsChildren whose parent had less than a high school degree had 35% higher CRP than those with a college graduate parent; and, poor children had 24% higher CRP than those with high family income, net of controls. When children's body mass index was accounted for, low education and poverty associations were reduced to 19% and 15%, respectively. Child age interactions were negative and significant for both parental education and family income.ConclusionsThis study provides new evidence that SES is associated with low-grade inflammation in children, and that these associations may be particularly strong during early and mid-childhood. Future research should further our understanding of stressors related to low family SES that may lead to immune system dysregulation during childhood.
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Hillier-Brown, Frances, Katie Thomson, Victoria Mcgowan, Joanne Cairns, Terje A. Eikemo, Diana Gil-Gonzále, and Clare Bambra. "The effects of social protection policies on health inequalities: Evidence from systematic reviews." Scandinavian Journal of Public Health 47, no. 6 (May 9, 2019): 655–65. http://dx.doi.org/10.1177/1403494819848276.
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Background: The welfare state distributes financial resources to its citizens – protecting them in times of adversity. Variations in how such social protection policies are administered have been attributed to important differences in population health. The aim of this systematic review of reviews is to update and appraise the evidence base of the effects of social protection policies on health inequalities. Methods/design: Systematic review methodology was used. Nine databases were searched from 2007 to 2017 for reviews of social policy interventions in high-income countries. Quality was assessed using the Assessment of Multiple Systematic Reviews 2 tool. Results: Six systematic reviews were included in our review, reporting 50 unique primary studies. Two reviews explored income maintenance and poverty relief policies and found some, low quality, evidence that increased unemployment benefit generosity may improve population mental health. Four reviews explored active labour-market policies and found some, low-quality evidence, that return to work initiatives may lead to short-term health improvements, but that in the longer term, they can lead to declines in mental health. The more rigorously conducted reviews found no significant health effects of any of social protection policy under investigation. No reviews of family policies were located. Conclusions: The systematic review evidence base of the effects of social protection policy interventions remains sparse, of low quality, of limited generalizability (as the evidence base is concentrated in the Anglo-Saxon welfare state type), and relatively inconclusive. There is a clear need for evaluations in more diverse welfare state settings and particularly of family policies.
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Cheer, Tarin, Robin Kearns, and Laurence Murphy. "Housing Policy, Poverty, and Culture: ‘Discounting’ Decisions among Pacific Peoples in Auckland, New Zealand." Environment and Planning C: Government and Policy 20, no. 4 (August 2002): 497–516. http://dx.doi.org/10.1068/c04r.
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This paper explores the links between housing and other welfare policies, low income, and culture among Pacific peoples within Auckland, New Zealand. These migrant peoples occupy an ambiguous social space within Auckland: they represent the visible face of the world's largest Polynesian city, yet are occupants of some of the city's poorest and least health-promoting housing. Through considering the balance between choice and constraint, we examine how housing costs, poverty, and cultural practices converge to influence household expenditure decisions. Specifically, we are interested in the ways health-promoting behaviours (for example, obtaining fresh food) and utilising health care services are ‘discounted’ (that is, postponed or substituted with cheaper alternatives) because of costs associated with structural changes in housing and the broader policy context. We draw on narratives gathered from in-depth interviews conducted with seventeen Samoan and Cook Island families undertaken in the South Auckland suburb of Otara in mid-2000. Our findings illustrate a lack of ‘fit’ between state housing stock and its occupants. We conclude that, although a recent return to a policy of income-related rents may alleviate these conditions, further longitudinal and community-supported research is required to monitor whether health inequalities are in fact lessened through income-related interventions alone.
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Pritchard, Colin, and Steven Keen. "Child mortality and poverty in three world regions (the West, Asia and Sub-Saharan Africa) 1988–2010: Evidence of relative intra-regional neglect?" Scandinavian Journal of Public Health 44, no. 8 (October 22, 2016): 734–41. http://dx.doi.org/10.1177/1403494816675550.
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Aims: Poverty kills children. This study assesses the relationship between poverty and child mortality rates (CMRs) in 71 societies from three world regions to determine whether some countries, relative to their region, neglect their children. Methods: Spearman rank order correlations were calculated to determine any association between the CMR and poverty data, including income inequality and gross national income. A current CMR one standard deviation (SD) above or below the regional average and a percentage change between 1988 and 2010 were used as the measures to assess the progress of nations. Results: There were positive significant correlations between higher CMRs and relative poverty measures in all three regions. In Western countries, the current CMRs in the USA, New Zealand and Canada were 1 SD below the Western mean. The narrowest income inequalities, apart from Japan, were seen in the Scandinavian nations alongside low CMRs. In Asia, the current CMRs in Pakistan, Myanmar and India were the highest in their region and were 1 SD below the regional mean. Alongside South Korea, these nations had the lowest percentage reductions in CMRs. In Sub-Saharan Africa, the current CMRs in Somalia, Burkina Faso, Sierra Leone, Chad, Democratic Republic of Congo and Angola were the highest in their region and were 1 SD below the regional mean. Conclusions: Those concerned with the pursuit of social justice need to alert their societies to the corrosive impact of poverty on child mortality. Progress in reducing CMRs provides an indication of how well nations are meeting the needs of their children. Further country-specific research is required to explain regional differences.
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Traoré, Médicoulé, Cécile Vuillermoz, Pierre Chauvin, and Séverine Deguen. "Influence of Individual and Contextual Perceptions and of Multiple Neighborhoods on Depression." International Journal of Environmental Research and Public Health 17, no. 6 (March 17, 2020): 1958. http://dx.doi.org/10.3390/ijerph17061958.
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The risk of depression is related to multiple various determinants. The consideration of multiple neighborhoods daily frequented by individuals has led to increased interest in analyzing socio-territorial inequalities in health. In this context, the main objective of this study was (i) to describe and analyze the spatial distribution of depression and (ii) to investigate the role of the perception of the different frequented spaces in the risk of depression in the overall population and in the population stratified by gender. Data were extracted from the 2010 SIRS (a French acronym for “health, inequalities and social ruptures”) cohort survey. In addition to the classic individual characteristics, the participants reported their residential neighborhoods, their workplace neighborhoods and a third one: a daily frequented neighborhood. A new approach was developed to simultaneously consider the three reported neighborhoods to better quantify the level of neighborhood socioeconomic deprivation. Multiple simple and cross-classified multilevel logistic regression models were used to analyze the data. Depression was reported more frequently in low-income (OR = 1.89; CI = [1.07–3.35]) or middle-income (OR = 1.91; CI = [1.09–3.36]) neighborhoods and those with cumulative poverty (OR = 1.64; CI = [1.10–2.45]). In conclusion, a cumulative exposure score, such as the one presented here, may be an appropriate innovative approach to analyzing their effects in the investigation of socio-territorial inequalities in health.
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Lerner, Richard M., Jonathan M. Tirrell, Patricia K. Gansert, Jacqueline V. Lerner, Pamela Ebstyne King, G. John Geldhof, Elizabeth M. Dowling, and Alistair T. R. Sim. "Longitudinal Research About, and Program Evaluations of, Positive Youth Development in Low- and Middle-Income Countries: Methodological Issues and Options." Journal of Youth Development 16, no. 2-3 (July 14, 2021): 100–123. http://dx.doi.org/10.5195/jyd.2021.1040.
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The study of positive youth development (PYD) requires theory-based methodological considerations pertinent to measurement, research and program design, and data analysis. We outline the appropriate steps that researchers and program evaluators must enact to address these methodological foci in their respective attempts to describe, explain, and optimize the course of positive development among diverse youth around the world. We focus on longitudinal (developmental) research designed to evaluate programs promoting PYD in low- and middle-income countries (LMICs), where life challenges are shaped by multiple adverse situations associated with racism, poverty, gender inequalities, political inequities, and the absence of adequate health and medical resources. Using the Compassion International Study of PYD as a sample case, we suggest how researchers and practitioners might collaborate to enact rigorous, theory-based research aimed at promoting PYD among youth living in LMICs and worldwide.
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Omore, Ibrahim, Richard Stephen Sheppard, and Stefani Beale. "Impact of socioeconomic status on the incidence and mortality of multiple myeloma in the United States." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e13595-e13595. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e13595.
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e13595 Background: Socioeconomic deprivation is known to be associated with poorer survival among cancer patients, but studies has not shown the impacts of socioeconomic status on the Incidence and mortality of multiple myeloma. This article analyzed the socioeconomic inequalities in United States Multiple Myeloma Incidence and Mortality. Methods: We examined national trends in the Incidence and Survival disparities among patients with Multiple Myeloma by race/ethnicity and socioeconomic status. A retrospective cohort of Multiple Myeloma patients diagnosed from 2012 to 2016 belonging to all age groups, genders, income per household and level of education was identified from Surveillance, Epidemiology and End results database, United States Cancer Statistics and Population data from Census Bureau. Results: We found mortality to be higher among African American and in States with low median household income and low level of education. In conclusion our study shows a strong correlation between social deprivation and decreased survival in patients with Multiple Myeloma in all age groups. Also we found that Asians and Pacific Islanders seems to have higher survival compare to African Americans and Other ethnicities. Conclusions: Census‐based socioeconomic measures such as poverty and education levels could serve as important surveillance tools for monitoring trends in cancer‐related health inequalities and targeting interventions.
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Poortinga, Wouter, Sarah E. Rodgers, Ronan A. Lyons, Pippa Anderson, Chris Tweed, Charlotte Grey, Shiyu Jiang, Rhodri Johnson, Alan Watkins, and Thomas G. Winfield. "The health impacts of energy performance investments in low-income areas: a mixed-methods approach." Public Health Research 6, no. 5 (March 2018): 1–182. http://dx.doi.org/10.3310/phr06050.
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BackgroundCold homes and fuel poverty contribute to health inequalities in ways that could be addressed through energy efficiency interventions.ObjectivesTo determine the health and psychosocial impacts of energy performance investments in low-income areas, particularly hospital admissions for cardiorespiratory conditions, prevalence of respiratory symptoms and mental health status, hydrothermal conditions and household energy use, psychosocial outcomes, cost consequences to the health system and the cost utility of these investments.DesignA mixed-methods study comprising data linkage (25,908 individuals living in 4968 intervention homes), a field study with a controlled pre-/post-test design (intervention,n = 418; control,n = 418), a controlled multilevel interrupted time series analysis of internal hydrothermal conditions (intervention,n = 48; control,n = 40) and a health economic assessment.SettingLow-income areas across Wales.ParticipantsResidents who received energy efficiency measures through the intervention programme and matched control groups.Main outcome measuresPrimary outcomes – emergency hospital admissions for cardiorespiratory conditions, self-reported respiratory symptoms, mental health status, indoor air temperature and indoor relative humidity. Secondary outcomes – emergency hospital admissions for chronic obstructive pulmonary disease-related cardiorespiratory conditions, excess winter admissions, health-related quality of life, subjective well-being, self-reported fuel poverty, financial stress and difficulties, food security, social interaction, thermal satisfaction and self-reported housing conditions.MethodsAnonymously linked individual health records for emergency hospital admissions were analysed using mixed multilevel linear models. A quasi-experimental controlled field study used a multilevel repeated measures approach. Controlled multilevel interrupted time series analyses were conducted to estimate changes in internal hydrothermal conditions following the intervention. The economic evaluation comprised cost–consequence and cost–utility analyses.Data sourcesThe Patient Episode Database for Wales 2005–14, intervention records from 28 local authorities and housing associations, and scheme managers who delivered the programme.ResultsThe study found no evidence of changes in physical health. However, there were improvements in subjective well-being and a number of psychosocial outcomes. The household monitoring study found that the intervention raised indoor temperature and helped reduce energy use. No evidence was found of substantial increases in indoor humidity levels. The health economic assessment found no explicit cost reductions to the health service as a result of non-significant changes in emergency admissions for cardiorespiratory conditions.LimitationsThis was a non-randomised intervention study with household monitoring and field studies that relied on self-response. Data linkage focused on emergency admissions only.ConclusionAlthough there was no evidence that energy performance investments provide physical health benefits or reduce health service usage, there was evidence that they improve social and economic conditions that are conducive to better health and improved subjective well-being. The intervention has been successful in reducing energy use and improving the living conditions of households in low-income areas. The lack of association of emergency hospital admissions with energy performance investments means that we were unable to evidence cost saving to health-service providers.Future workOur research suggests the importance of incorporating evaluations with follow-up into intervention research from the start.FundingThe National Institute for Health Research Public Health Research programme.
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Power, Madeleine, Bob Doherty, Katie Pybus, and Kate Pickett. "How Covid-19 has exposed inequalities in the UK food system: The case of UK food and poverty." Emerald Open Research 2 (April 3, 2020): 11. http://dx.doi.org/10.35241/emeraldopenres.13539.1.
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This article draws upon our unique perspective as academic-practitioners working in the fields of food insecurity, food systems, and inequality to comment on the empirical and ethical implications of Covid-19 for socio-economic inequalities in access to food in the UK. The Covid-19 pandemic has revealed the profound insecurity of large segments of the UK population; increased unemployment, reduced hours, and enforced self-isolation for multiple vulnerable groups is likely to lead to an increase in UK food insecurity, exacerbating diet-related health inequalities. The social and economic crisis associated with the pandemic has exposed the fragility of the system of food charity which, at present, is a key response to growing poverty. A vulnerable food system, with just-in-time supply chains, has been challenged by stockpiling. Resultant food supply issues at food banks, alongside rapidly increasing demand and reduced volunteer numbers, has undermined many food charities, especially independent food banks. In the light of this analysis, we make a series of recommendations for social security policy, ‘emergency’ food provision, and retailers. We call for an immediate end to the five week wait for Universal Credit and cash grants for low income households. We ask central and local government to recognise that many food aid providers are already at capacity and unable to adopt additional responsibilities. We urge supermarkets to commit to paying their employees the Real Living Wage to mitigate against food insecurity amongst their staff now and in the future. The government’s -- impressive -- response to the economic crisis associated with Covid-19 has underscored a key principle: it is the government’s responsibility to protect population health, to guarantee household incomes, and to safeguard the economy. Millions of households were in poverty before the pandemic, and millions more will be so unless the government continues to protect household incomes through policy change.
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Power, Madeleine, Bob Doherty, Katie Pybus, and Kate Pickett. "How COVID-19 has exposed inequalities in the UK food system: The case of UK food and poverty." Emerald Open Research 2 (May 13, 2020): 11. http://dx.doi.org/10.35241/emeraldopenres.13539.2.
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This article draws upon our perspective as academic-practitioners working in the fields of food insecurity, food systems, and inequality to comment, in the early stages of the pandemic and associated lockdown, on the empirical and ethical implications of COVID-19 for socio-economic inequalities in access to food in the UK. The COVID-19 pandemic has sharpened the profound insecurity of large segments of the UK population, an insecurity itself the product of a decade of ‘austerity’ policies. Increased unemployment, reduced hours, and enforced self-isolation for multiple vulnerable groups is likely to lead to an increase in UK food insecurity, exacerbating diet-related health inequalities. The social and economic crisis associated with the pandemic has exposed the fragility of the system of food charity which, at present, is a key response to growing poverty. A vulnerable food system, with just-in-time supply chains, has been challenged by stockpiling. Resultant food supply issues at food banks, alongside rapidly increasing demand and reduced volunteer numbers, has undermined many food charities, especially independent food banks. In the light of this analysis, we make a series of recommendations. We call for an immediate end to the five week wait for Universal Credit and cash grants for low income households. We ask central and local government to recognise that many food aid providers are already at capacity and unable to adopt additional responsibilities. The government’s - significant - response to the economic crisis associated with COVID-19 has underscored a key principle: it is the government’s responsibility to protect population health, to guarantee household incomes, and to safeguard the economy. Millions of households were in poverty before the pandemic, and millions more will be so unless the government continues to protect household incomes through policy change.
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SORI, ASSEFA TOLERA. "POVERTY, SEXUAL EXPERIENCE AND HIV VULNERABILITY RISKS: EVIDENCE FROM ADDIS ABABA, ETHIOPIA." Journal of Biosocial Science 44, no. 6 (May 17, 2012): 677–701. http://dx.doi.org/10.1017/s0021932012000193.
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SummaryThis study explores the relationship between poverty and vulnerability to HIV infection in Ethiopia using primary (quantitative and qualitative) and secondary data from two sub-cities of Addis Ababa. The data show that sexual experience is influenced by diverse factors such as age, gender, economic status and education level. Household economic status and migration explain the nature of sexual experience and level of vulnerability to HIV infection. Poor uneducated women in poor neighbourhoods are more likely to engage in risky sexual encounters despite awareness about the risk of HIV infection as they operate in an environment that provides the ‘path of least resistance’ (Lindegger & Wood, 1995, p. 7). This article argues that poverty provides a situation where early sexual initiation, ‘transactional sex’ and an inability to negotiate for safer sex are associated with low income, lack of education and increased vulnerability to HIV infection. This vulnerability is simultaneously contested and accepted as a commitment to even sacrifice one's life for the sake of one's loved ones. As a modest contribution to the ‘structural violence’ approach, which emphasizes social inequalities based on gender, class, ethnicity and race and inequalities in terms of exposure to risk and access to health care (Massé, 2007), this article challenges the ‘African promiscuity’ discourse, which ‘does not permit policymakers to think beyond sex’ (Stillwaggon, 2006, p. 156), and encourages researchers and policymakers to ask the right questions to understand the complexity of HIV/AIDS and seek solutions to the pandemic.
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Gabil, Hanan, Benaouda Bensaid, Tahar Tayachi, and Faleel Jamaldeen. "The Need for Shari’ah-Compliant Awqāf Banks." Journal of Risk and Financial Management 13, no. 4 (April 17, 2020): 76. http://dx.doi.org/10.3390/jrfm13040076.
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Bridging global economic inequalities calls for effective financial alternatives such as awqāf banks to better attend to the needs of the poor and underprivileged. This is expected to address the root causes of poverty and ensuing economic gaps, improving much of the living standards whether pertaining to education, health, shelter, employment or basic social services while reducing the state’s economic and financial burden. We envision awqāf banks as institutions which are established through cash awqāf and which operate multiple awqāf funds alongside an assortment of financial instruments. The main use of their awqāf funds are the issue of low-cost credit to the poor, economically disadvantaged and underprivileged, instead of focusing solely on generating and maximizing shareholder profits. This is to support the economy through of steady and sustainable growth, effectively raising the lower bar on per capita income and lifting multitudes out of poverty and need. This paper explores how low-cost credit can be provided to the poor or lower income demographics through awqāf banks, while addressing relevant issues such as Shari’ah compliance, services rendering, investment and awqāf distribution. This paper also examines current studies on awqāf in relation to finance and banking, the basic functions, and characteristics of the Shari’ah-compliant awqāf bank, as well as evaluations of awqāf banks. Current studies show that there is a legitimate need for Shari’ah-compliant awqāf banks which not only providing services for its beneficiaries but also manage investments and awqāf funds that contribute to overall national development and economic growth. This study would be of high relevance to experts, practitioners, financial managers, regulators, and policy makers in the fields of awqāf, banking and finance.
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Makombe, Eric Kushinga. "“Between a Rock and a Hard Place”: The Coronavirus, Livelihoods, and Socioeconomic Upheaval in Harare’s High-Density Areas of Zimbabwe." Journal of Developing Societies 37, no. 3 (July 12, 2021): 275–301. http://dx.doi.org/10.1177/0169796x211030062.
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For Zimbabwe, the confirmed Covid-19 deaths for 2020 numbered in the hundreds, not thousands. Still, Covid-19 could not have come at a worse time owing to a myriad of crises the country was going through. As a result, the Covid-19 pandemic was much more than a public health crisis as it threatened already vulnerable people, putting lives and livelihoods at risk. This article focuses on the socioeconomic impact of the novel coronavirus pandemic, examining the social pattern of its unfolding and impact, analyzing the institutional and communal responses to the disease, and marking the effects of its aftermath in Harare’s high-density residential spaces. The research design captures a broad empirical picture of what was happening by specifically drawing on case study examples from Harare, the capital city of Zimbabwe. The broad objective of the research brings out how low-income households experienced the Covid-19 pandemic compared to higher-income households as informed by sex-based differences, access to healthcare, and food. It also captures the differential impacts and inequalities in socioeconomic outcomes, livelihoods, poverty reduction, and human development informing these household experiences. Beyond this, the study captures and highlights how the Covid-19 crisis led to widespread instances of food insecurity, economic anxiety, and general disenfranchisement from alternative sources of income that, in turn, created further social upheaval. The last strand of this article exposes the implications of some of the public health measures instituted in attempts to tackle Covid-19.
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WOJCICKI, JANET MAIA. "SOCIOECONOMIC STATUS AS A RISK FACTOR FOR HIV INFECTION IN WOMEN IN EAST, CENTRAL AND SOUTHERN AFRICA: A SYSTEMATIC REVIEW." Journal of Biosocial Science 37, no. 1 (December 8, 2004): 1–36. http://dx.doi.org/10.1017/s0021932004006534.
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This is a critical, systematic review of the relationship between socioeconomic status (SES) and HIV infection in women in Southern, Central and Eastern Africa. In light of the interest in micro-credit programmes and other HIV prevention interventions structured to empower women through increasing women’s access to funds and education, this review examines the epidemiological and public health literature, which ascertains the association between low SES using different measurements of SES and risk of HIV infection in women. Also, given the focus on structural violence and poverty as factors driving the HIV epidemic at a structural/ecological level, as advocated by Paul Farmer and others, this study examines the extent to which differences in SES between individuals in areas with generalized poverty affect risk for SES. Out of 71 studies retrieved, 36 studies met the inclusion criteria including 30 cross-sectional, one case-control and five prospective cohort or nested case-control studies. Thirty-five studies used at least one measurement of female’s SES and fourteen also included a measurement of partner’s SES. Studies used variables measuring educational level, household income and occupation or employment status at the individual and neighbourhood level to ascertain SES. Of the 36 studies, fifteen found no association between SES and HIV infection, twelve found an association between high SES and HIV infection, eight found an association between low SES and HIV infection and one was mixed. In interpreting these results, this review examines the role of potential confounders and effect modifiers such as history of STDs, number of partners, living in urban or rural areas and time and location of study in sub-Saharan Africa. It is argued that STDs and number of partners are on the causal pathway under investigation between HIV and SES and should not be adjusted as confounders in any analysis. In conclusion, it is argued that in low-income sub-Saharan Africans countries, where poverty is widespread, increasing access to resources for women may initially increase risk of HIV or have no effect on risk-taking behaviours. In some parts of Southern Africa where per capita income is higher and within-country inequalities in wealth are greater, studies suggest that increasing SES may decrease risk. This review concludes that increased SES may have differential effects on married and unmarried women and further studies should use multiple measures of SES. Lastly, it is suggested that the partner’s SES (measured by education or income/employment) may be a stronger predictor of female HIV serostatus than measures of female SES.
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Karaalp-Orhan, Hacer Simay. "Regional Disparities in Turkey: A Socio-Economic Perspective." European Journal of Sustainable Development 9, no. 3 (October 1, 2020): 103. http://dx.doi.org/10.14207/ejsd.2020.v9n3p103.
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Economic development, for any country, is one of the most important objectives to be achieved. However, development cannot be realized in all regions and provinces of a county at the same time and speed. Turkey also struggles against a persistent economic development problem among regions in east-west and coast-inland for many years. This study aims to analyze the regional inequalities in Turkey under the scope of economic, demographic and social indicators from 2007 to the latest data. The results indicate that TR-10 Istanbul is the engine region of Turkey in terms of industrialization and development with the highest contribution (31%) based on service and industry sectors, to the gross value added. Other industrialized regions are the Aegean region where localization economies mainly dominated and the East Marmara and TR51-Ankara regions where urbanization economies operated in. Agricultural activities heavily concentrated in Aegean, Antalya, Konya and Şanlıurfa regions. In these regions, participation in the labour market is also very high. However, the highest income inequality and poverty is also found in TR10, TR62 and TR21 regions. The less developed region is the Southeast Anatolian region in terms of low income, education, health and high unemployment, young population and immigration rates. Keywords: Regional disparities, regional development, socio-economic indicators, Turkey
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Habib, Rima R., Nataly W. El-Haddad, Kareem Elzein, and Safa Hojeij. "Mental and self-rated health of bakery workers in Lebanon: A national study." SAGE Open Medicine 8 (January 2020): 205031212096234. http://dx.doi.org/10.1177/2050312120962345.
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Objectives: The relationship between poverty and health has been well addressed in public health research. The health effects of social and economic inequalities on working groups have also drawn the attention of occupational health scholars. Research addressing workers in low-paying jobs showed increased risks for poor health. This research examined the psychosocial factors associated with poor mental health and self-rated health among low-income bakery workers performing demanding tasks. Methods: Face-to-face interviews in 504 randomly selected bakeries in Lebanon provided data on socio-demographics, perception of the workplace environment, job security, job satisfaction, general health, and mental health. Results: In total, 16.5% of bakery workers reported poor self-rated health, and 45% reported poor mental health. Workers with a chronic illness were almost three times more likely to report poor self-rated health (OR = 2.86; 95% CI = 1.44–5.67), and those with musculoskeletal pain reported poor self-rated health five times as often (OR = 5.34; 95% CI = 2.9–9.80). Those with a chronic illness and musculoskeletal pain were twice as likely to report poor mental health (OR = 1.94; 95% CI = 1.07–3.50 and OR = 2.07; 95% CI = 1.32–3.23, respectively); and those dissatisfied with their job reported poorer self-rated health (OR = 2.18; 95% CI = 1.12–4.23) and mental health (OR = 2.57; 95% CI = 1.54–4.26). In addition, workers reporting job insecurity had poor mental health twice as often (OR = 1.93; 95% CI = 1.24–2.99). Low socioeconomic indicators showed a gradient association with both poor self-rated health and mental health. Conclusion: Reporting job dissatisfaction and insecurity, musculoskeletal pain, and chronic illness were associated with poor mental and self-rated health among bakery workers. Interventions to improve the working conditions of bakery workers are timely and essential. This research provided evidence for policy to guide occupational health practice and safeguard the health of bakery workers.
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Atamari-Anahui, Noé, Maycol Suker Ccorahua-Rios, Mirian Condori-Huaraka, Yerika Huamanvilca-Yepez, Elard Amaya, and Percy Herrera-Añazco. "Epidemiology of chronic kidney disease in Peru and its relation to social determinants of health." International Health 12, no. 4 (October 31, 2019): 264–71. http://dx.doi.org/10.1093/inthealth/ihz071.
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Abstract Background Chronic kidney disease (CKD) is a growing public health problem and an important cause of morbidity and mortality. Disparities in CKD may be related to social determinants and health inequalities in low- and middle-income countries. This study determined how social determinants of health influence trends in the prevalence and mortality of CKD in Peru. Methods This was an ecological study based on a secondary analysis of health care and death records obtained from the Ministry of Health of Peru for the period 2010–2016. The standardized prevalence and mortality rates of CKD were descriptively reported using geospatial exploratory analysis. We also determined the association with social determinants of health according to the domains suggested by Healthy People 2020. Results In the studied period, CKD prevalence increased by 300% and was associated with the health insurance coverage rate (β=5.9 [95% CI 0.82 to 10.92]), proportion of people with a secondary education level (β=11.4 [95% CI 1.94 to 20.93]), mean age (β=−10.7 [95% CI −19.33 to −2.12]), monetary poverty rate (β=−2.2 [95% CI −3.88 to −0.60]) and gross domestic product per capita (β=−63.2 [95% CI −117.81 to −8.52]). The standardized mortality decreased by 10% and was associated with mean age (β=−0.6 [95% CI −1.22 to −0.06]) and the proportion of people with a primary education level (β=−0.5 [95% CI −0.9 to −0.05]). Conclusions During the period 2010–2016, the prevalence of CKD increased and the mortality associated with CKD decreased. The observed changes were associated with some social determinants of health, such as increased health coverage and education. The health system of Peru must be prepared to take on the challenge.
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Zissi, Anastasia, and George Stalidis. "Social class and mental distress in Greek urban communities during the period of economic recession." International Journal of Social Psychiatry 63, no. 5 (June 12, 2017): 459–67. http://dx.doi.org/10.1177/0020764017712743.
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Background: This study draws on old and well-established evidence that economic change, and especially recession, affects people’s lives, behavior and mental health. Even though the literature is rich on the relationship between unemployment and mental distress, there is a renewed research interest on the link between socio-economic inequalities and psychological health. Aims: The study investigates the relationship of social class with mental distress during the hard times of persistent and severe economic crisis in Greece by conducting a comparative, community study in the country’s second largest city, Thessaloniki. Method: A face-to-face structured interview covering living conditions, life events, chronic stressors and coping strategies was employed to 300 residents of socio-economically contrasting neighborhood areas. Social class was operationalized by Erik Olin Wright’s social class position typology, based on ownership and control over productive assets. The method of multiple correspondence analysis (MCA) was also applied to analyze the collected data. Results: The results indicated that mental distress was significantly differentiated across social classes and in each residential area. Unemployed and unskilled workers were the most vulnerable groups in terms of psychological health. Chronic stress arose in this study as a risk factor for poor mental health outcomes and it was associated to low marital quality, intense economic burden and impoverished housing conditions. Conclusion: Those who face income loss, job loss and disability are at high risk for poverty and marginalization, suffering from greater psychological distress.
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Załuski, Wojciech. "O egalitaryzmie ekonomicznym." Filozofia Publiczna i Edukacja Demokratyczna 5, no. 1 (June 4, 2018): 12–36. http://dx.doi.org/10.14746/fped.2016.5.1.2.
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Economic egalitarianism, i.e., the view according to which equality of resources is a social value, has two different forms: the intrinsic and the instrumental. According to the former economic equality is a value in itself (i.e., an ‘intrinsic’ value), whereas according to the latter it is an ‘instrumental’ value, i.e., it is a value in so far as it contributes to the realization of some other values (which, as opposed to equality, are intrinsic), such as, e.g. the alleviation of suffering, higher quality of life, political freedom, or fraternity. Intrinsic egalitarianism is a controversial view, as it is susceptible to the famous ‘levelling down’ objection (formulated by Derek Parfit). We formulate in the paper two main arguments for the view that instrumental egalitarianism is not plausible as well. The first argument says that it is difficult to demonstrate that social and health problems conceived by the adherents of instrumental economic egalitarianism (such as, e.g., Richard Wilkinson and Kate Pickett) as the effects of inequalities of resources are really caused by these inequalities; we argue that it is more plausible, at least with regard to some of these effects, to maintain that their cause is poverty (and thereby the low absolute, rather than relative, level of income). According to the second argument, even if the adherents of instrumental economic egalitarianism are right in claiming that there exists a causal link between economic inequalities and social and health problems, it would not be sufficient to morally justify their egalitarian view, since the link is to a large extent based upon morally dubious psychological mechanisms, such as envy or the proclivity to overestimate the importance of material resources. Finally, we argue that the view which best harmonizes with the above critique of egalitarianism is the ‘doctrine of sufficiency’ proposed by Harry Frankfurt, which implies that what is important is not equality of resources but that all persons have enough of them.
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Mwesigwa, Catherine Lutalo, Brenda Akinyi Okumu, Charity Kirabo-Nagemi, Emma Ejuu, Estie Kruger, and Marc Tennant. "Mapping the geographic availability of public dental services in Uganda relative to ruralization and poverty of the population." Journal of Global Oral Health 2 (February 29, 2020): 86–92. http://dx.doi.org/10.25259/jgoh_66_2019.
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Objectives: Uganda is a low-income country faced with a number of challenges in health service delivery, including oral health services. Despite reports of an increased prevalence of oral diseases, they are afforded less priority, amidst competing priorities of infectious and other non-communicable diseases. Oral health-care services are offered free-of-charge in public health facilities. The majority of the Ugandan population live in rural areas. This would imply that public dental services should be more widely distributed in rural areas to meet the needs of the majority population. This study, therefore, aimed to determine the geographic distribution of public dental services relative to poverty and ruralization of the Ugandan population. Materials and Methods: All 112 districts in Uganda were to be surveyed for this study using an ecological design that incorporated the Ugandan population with socio-demographics obtained from the latest Uganda National Housing and Population Census and poverty data from the national Poverty Status Report 2014. The data from the districts were on the availability of public dental services and the physical location of these dental facilities. Overall, 182 public facilities were included in the study. The geographic location of public dental clinics was established using open-data sources. The data on ruralization were aggregated at the district level and that on poverty at the subregion level. Spatial analysis was done using geographic information science software, Quantum Geographic Information System. Results: The total Ugandan population was 34 million. Overall, 19.7% of the population was poor with the highest proportion located in the North and East of Uganda. Urban-rural characteristics varied across the country. Information on the 182 public dental clinics was collected from 97 of the 112 Ugandan districts. Among the 97 districts, 15% had no public clinic and were located in the poorest Ugandan regions. Among the 40 districts containing over 90% of the rural population, 20% had none, and 55% only had one dental clinic. In general, service availability reduced as the proportion of the rural and poor population increased. Conclusion: The spatial analysis presents an avenue to inform and guide the decision making and planning process by identifying geographic areas with access gaps relative to population socio-demographic characteristics. This study revealed that public dental services were least available for the poorest and rural populations, and yet they are already vulnerable to other access barriers. It is recommended that efforts should be made by health planners and policymakers to avert the health inequalities presented by inequitable access.
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Gregório, Maria João, Pedro Graça, Andreia Costa, and Paulo Jorge Nogueira. "Time and regional perspectives of food insecurity during the economic crisis in Portugal, 2011-2013." Saúde e Sociedade 23, no. 4 (December 2014): 1127–41. http://dx.doi.org/10.1590/s0104-12902014000400001.
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Food insecurity (FI) has received much attention in recent years, even in high-income countries, due to the increasing trend of poverty and social inequalities indicators, as a result of the global financial crisis. The establishment of a monitoring system of FI becomes a priority for food and nutrition policies. Our study aims to evaluate FI trends during the economic crisis in Portugal and to identify regional disparities throughout the country. Data derived from three surveys conducted by the Portuguese Directorate-General of Health, concerning FI of the Portuguese population, during the period that Portugal was under the International Monetary Fund financial assistance program (2011–2013). Data were collected by face-to-face interviews and FI was evaluated using a psychometric scale. Logistic regression models were used to identify regional disparities in FI. The prevalence of FI was relatively unchanged at national and regional levels, during the analysis period. Data from 2013 indicates a high prevalence of FI (50.7%), including 33.4% for low FI, 10.1% for moderate FI and 7.2% for severe FI. Disparities according health region were also found for household FI. Algarve, Lisboa and Vale do Tejo were the two regions with the highest levels of FI, even after controlling for other socioeconomic variables. High levels of FI found in Portugal and the different regional profiles suggest the need for regional strategies, in particular in the most affected regions based on a broader action with different policy sectors (health, social security, municipalities and local institutions in the field of social economy).
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Hovhannisyan, Lilit, Anahit Demirchyan, and Varduhi Petrosyan. "Estimated prevalence and predictors of undernutrition among children aged 5–17 months in Yerevan, Armenia." Public Health Nutrition 17, no. 5 (May 14, 2013): 1046–53. http://dx.doi.org/10.1017/s1368980013001171.
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AbstractObjectiveChild undernutrition is a serious public health problem in many low- and middle-income countries. Data on child undernutrition prevalence and its risk factors in Armenia are limited. The present study aimed to estimate the prevalence and explore the predictors of undernutrition among children aged 5–17 months in Yerevan.DesignThe study was cross-sectional and employed a review of the ambulatory charts of children selected through a multistage cluster sampling. This phase was followed by a case–control study. The cases were undernourished children identified during the record review and randomly matched with normally growing controls of the same age and gender from the same pool of records. Mothers of cases and controls participated in a telephone interview. The study used conditional logistic regression analysis.SettingYerevan, Armenia.SubjectsChildren aged 5–17 months residing in Yerevan, Armenia.ResultsReview of 570 ambulatory charts suggested the prevalence of stunting, underweight and wasting among 5–17-month-old children in Yerevan to be 17·9 %, 7·3 % and 3·1 %, respectively. The case–control study of eighty-nine matched pairs identified four significant predictors of child undernutrition: family's socio-economic status score (P = 0·030), child's length at birth (P = 0·027), duration of predominant breast-feeding (P = 0·046) and food diversity score (P = 0·039).ConclusionsThe factors determining growth patterns of children in Yerevan are mostly behavioral and environmental, hence modifiable. Reducing poverty and inequalities in food availability, promoting breast-feeding and adequate complementary feeding, and ensuring optimal care before, during and after pregnancy are likely to help reduce child undernutrition in Yerevan, Armenia and societies with similar public health concerns.
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Siegel, M. "Inequalities in Income and Health Related to Child Poverty." JAMA: The Journal of the American Medical Association 301, no. 22 (June 9, 2009): 2328–29. http://dx.doi.org/10.1001/jama.2009.769.
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Emerson, Eric. "Inequalities in Income and Health Related to Child Poverty—Reply." JAMA 301, no. 22 (June 10, 2009): 2328. http://dx.doi.org/10.1001/jama.2009.770.
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Tabassum, Amina, and M. Tariq Majeed. "Economic Growth and Income Inequality Relationship: Role of Credit Market Imperfection." Pakistan Development Review 47, no. 4II (December 1, 2008): 727–43. http://dx.doi.org/10.30541/v47i4iipp.727-743.
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The 20th century has witnessed unequalled success in improving the living standard of people in most part of the world. According to World Bank annual Statistical reports, poverty has declined significantly in developing countries over the past twenty years but the progress has been uneven. The number of people living in poverty fell from 1.5 billion in 1981 to 1.1 billion in 2001. However, many low-income developing countries are still trapped in vicious circle of poverty. In Sub-Saharan Africa, the number of poor rose from 41 percent to 46 percent between 1981 to 2001.While in Eastern Europe and Central Asia, the numbers of poor people have risen to around 20 percent in 2001.1 Therefore; reduction of widely scattered poverty is the most challenging goal for low income developing countries. Economic growth is considered to be a powerful force for reducing poverty. High and sustained economic growth increases the labor demand and wages which in return will reduce poverty. Similarly, better earnings as a result of reduction in poverty lead to increase productivity and growth. But the extent of poverty reduction as a result of economic growth depends on how the distribution of income changes with economic growth and on initial Inequalities in income. If income inequality increases, then economic growth does not lead to a significant poverty reduction. Many developing countries achieved high growth rates in different periods but poverty does not reduce significantly in these periods due to increase in income inequalities. Most South and East Asian economies grew at higher per capita rates since early 1970 along with rise in income inequality over time. In contrast, Latin American countries grew by less than the half of average growth rates in South and East Asia while maintaining high income inequality.2 The differences in income inequality at a given rate of growth require that efforts to reduce poverty by stimulating growth are not sufficient and need to be complemented by efforts to reduce income inequalities.
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ÖNÜR, Hıdır, and Berkay ERGÖZ. "THE DEAL WITH POVERTY STRATEGIES OF WOMEN IN LOW INCOME FAMILIES." Zeitschrift für die Welt der Türken / Journal of World of Turks 13, no. 1 (April 15, 2021): 199–225. http://dx.doi.org/10.46291/zfwt/130111.
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The fact of poverty one of the ways global inequalities appears affects societies especially in developing countries but this impact occurs in different forms and levels in different segments of population (women, the elderly, children, etc.). Therefore, different segments of population can develop different strategies to cope with the negative consequences of poverty. In this study, it is aimed to determine which strategies women have developed to combat poverty in low income families. For this purpose, indepth interviews were conducted with 8 women selected by purposeful sampling from low income families within the scope of qualitative research method. The interviews using the semi-structured interview form were conducted face to face. The data obtained from the interviews were evaluated using thematic analysis method. The research concluded that women have developed five strategies to combat poverty and the themes on which these strategies are evaluated are: (i) Delaying needs strategy, (ii) Optimal spending strategy, (iii) Household production strategy, (iv) Multi-use strategy, (v) Avoiding waste strategy. Key Words: Poverty, dealing with poverty strategies, low income families, women.
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De Santiago, Isabel, Leonor Bacelar Nicolau, Rui Tato Marinho, and José Pereira-Miguel. "Comunicação em Saúde Pública na Prevenção do Consumo Excessivo de Álcool e Drogas na População Escolar de São Tomé e Príncipe: Protocolo Científico." Acta Médica Portuguesa 33, no. 4 (April 1, 2020): 229. http://dx.doi.org/10.20344/amp.13435.
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Introduction: Sao Tome and Principe is an African low-and-middle-income country, where extreme poverty causes major health inequalities. No systematic research has been done on the consumption of alcohol and drugs in Sao Tome and Principe, and only overall statistics are available based on the importation of alcoholic drinks and their distribution among the population. There are also no studies on consumption of alcohol and illicit substances in children and youth and no preventive measures being undertaken. Besides that, manual databases present significant limitations, considering the lack of causes associated with mortality rates (0 - 5 years and > 5), and the difficulty to establish a cause/effect relation between diseases, deaths and life expectancy. No relevant data with burden of life was found in the reports of Centro Nacional de Endemias or the non-governmental, organization Instituto Marques de Valle Flor, a facilitator on healthcare clinical specialties selected on a voluntary basis by doctors from Portuguese hospitals. So, we proposed to provide a first overview of family and housing conditions, and above all, the consumption of alcohol and illegal drugs in young people. Thus, a project, the National Survey on Harmful Consumption of Alcohol and Drugs in Schools of Sao Tome and Principe, will be realized in order to better characterize the situation among children and young students and test public health communication strategies and preventive interventions aimed at this target-population. Interventions were designed taking into consideration local sociocultural realities of target audiences. We considered dialect language, single-parent families (matriarchal structure) and polygamy (mostly) in men and a country and governments led by men (patriarchal structure) and, in which the woman’s role, as Food and Agriculture Organization of the United Nations reports, remains overlooked. Subsequently, we will collect traditional alcohols samples from the two main islands for analysis (at Laboratório de Estudos Farmacêuticos and Laboratório Nacional de Engenharia Civil - Portugal) and to determine heavy metals in the production process and impact on burden of life.Material and Methods: In order to characterise the country’s situation in terms of alcohol and illicit substances consumption a literature review was carried out through a search in several international electronic databases, such as those of the World Health Organization, World Health Organization Africa, United Nation, The Lancet and Lancet Global Health, etc. Available data of the following institutions of Sao Tome and Príncipe was also analyzed: National Institute of Statistics, Ministry of Education, Culture and Training and Ministry of Health and Social Affairs. Several interviews with community and church leaders as well as with members of catholic missions were carried out to better understand the local situation. Following this, a nationwide cross-sectional survey of a sample of 2064 students will be carried out. This will include a questionnaire on socio-demographic characteristics, lifestyles, health behaviors/attitudes, alcohol and illicit substances consumption. Finally, based on the overall diagnosis obtained, some edutainment health communication preventive interventions will be tested in the primary schools of three districts (EDUCA_TURTLE) and on the radio journalists (EDUCA_PRESS). These were evaluated by primary school teachers and by radio journalists.
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Jones, Russell, and John Llewellyn. "Reducing Inequalities." National Institute Economic Review 250 (November 2019): R75—R82. http://dx.doi.org/10.1177/002795011925000121.
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Executive SummaryA backlash against numerous inequalities – and in particular against perceived unfairness in society – is a significant driver of the UK's current political malaise. Addressing inequalities between income groups, regions and generations will thus be key to re-establishing faith in government and avoiding further decline or even the threat of social unrest.In income terms, the UK has become much more unequal than in the immediate post-war decades, and it should be a goal to reverse that trend – targeting the OECD average for income inequality and a halving of the number of those living below the poverty line. Measures to deal with perceived unfairnesses could include tighter scrutiny of competition in high-yielding sectors such as technology, and incentives for the appointment of worker representatives to company boards. But a government intent on tackling inequalities will inescapably need to raise public spending and direct taxation of income and capital from their current historically low levels. In particular spending on education and active labour market policies needs to increase, while gaps in the benefits system and regional imbalances are addressed.Given the scale of technological change and the severe implications for the labour market, the risk is that policy will be insufficiently bold to deal with widespread disenchantment, which could ultimately pose a threat to democracy.
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Plouffe, Louise A. "Addressing social and gender inequalities in health among seniors in Canada." Cadernos de Saúde Pública 19, no. 3 (June 2003): 855–60. http://dx.doi.org/10.1590/s0102-311x2003000300018.
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Although canadian seniors enjoy economic security and good health and have made substantial gains in recent decades, this well-being is not equally shared among socioeconomic groups and between men and women. As for younger age groups, income predicts health status in later life, but less powerfully. Potential alternative explanations include an overriding influence of the aging process, the subjective effects of income loss at retirement and the attenuation of the poverty gap owing to public retirement income. Older women are more likely to age in poverty than men, to live alone and to depend on inadequately resourced chronic health care and social services. These differences will hold as well for the next cohort of seniors in Canada. Addressing these disparities in health requires a comprehensive, multisectoral approach to health that is embodied in Canada's population health model. Application of this model to reduce these disparities is described, drawing upon the key strategies of the population health approach, recent federal government initiatives and actions recommended to the government by federal commissions.
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Joffe, Michael. "Health, Livelihoods, and Nutrition in Low-Income Rural Systems." Food and Nutrition Bulletin 28, no. 2_suppl2 (June 2007): S227—S236. http://dx.doi.org/10.1177/15648265070282s202.
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Background Absolute poverty remains a major challenge: the proportion of the world population living with hunger, food insecurity, and undernutrition has fallen, but the absolute number remains stubbornly large. An even larger number of people have enough to eat but suffer from severe micronutrient deficiencies. Objectives To provide a conceptual framework showing the interdependence of hunger and poverty with ill health among the rural poor. Methods Review of the relevant health, nutrition, agriculture, and economics literature and organization of the findings into a systems framework. Results Economic growth is not a sufficient answer to rural poverty. The predicament of poor households can be represented in terms of a self-reinforcing cycle involving nutrition, health, and productivity. The degree of poverty limits the quantity and quality of food intake. Macro- and micronutrient deficiencies interfere with child growth and development and impair immune function, resulting in a predisposition to infectious diseases. Health status strongly influences the quantity and quality of labor and achieved educational status. The high risk of child mortality prevents households from going through the demographic transition to smaller families and better-educated children. The death of a working adult may be catastrophic for the household. This self-reinforcing cycle means that the beneficial effects of an intervention are propagated around the cycle, potentiating its impact. Each main element—nutrition, health, and productivity—also has numerous other determinants and can be influenced by interventions. Interventions that increase the carrying capacity of the household's environment are likely to be more sustainable than “technical fixes,” such as lifesaving medical treatment. Conclusions The self-reinforcing cycle is likely to be self-perpetuating without outside intervention. For any rural area where poverty reduction is planned, the key bottlenecks need to be identified. This can be done by using a causal diagram, as described in this paper.
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Ahmadabadi, Zohre, Jackob M. Najman, Gail M. Williams, and Alexandra M. Clavarino. "Income, Gender, and Forms of Intimate Partner Violence." Journal of Interpersonal Violence 35, no. 23-24 (July 27, 2017): 5500–5525. http://dx.doi.org/10.1177/0886260517719541.
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Poverty and socioeconomic disadvantage place demands on intimate relationships and provide fertile ground for disagreements and conflicts. It is not known whether poverty also leads to intimate partner violence (IPV). This study investigates the association between income and forms of IPV victimization for both males and females. We also examine whether income inequalities are related to IPV and whether the gender balance of household income contributes to IPV victimization. Data are from a cohort of 2,401 young offspring (60.3% females) who participated at the 30-year follow-up of the Mater-University of Queensland Study of Pregnancy in Brisbane, Australia. Participants completed questionnaires including their income details and the Composite Abuse Scale. Within low-income families, both partners experience higher levels of IPV. Females’ income is not independently related to experiencing IPV either for females or males. Females and males experience a higher rate of IPV when the husband earns a low income. When considering partners’ relative income, families in which both partners earned a low income experienced higher levels of almost all forms of IPV. Income (im)balance in which females earn more or partners both have higher income was less often associated with the experience OF IPV IPV appears to be mutually experienced in the setting of the poverty. Objective economic hardship and scarcity create a context which facilitates IPV for both partners in a relationship.
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Eozenou, Patrick Hoang-Vu, Sven Neelsen, and Magnus Lindelow. "Child Health Outcome Inequalities in Low and Middle Income Countries." Health Systems & Reform 7, no. 2 (July 1, 2021): e1934955. http://dx.doi.org/10.1080/23288604.2021.1934955.
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Arntzen, Annett, Tormod Bøe, Espen Dahl, Nina Drange, Terje A. Eikemo, Jon Ivar Elstad, Elisabeth Fosse, et al. "29 recommendations to combat social inequalities in health. The Norwegian Council on Social Inequalities in Health." Scandinavian Journal of Public Health 47, no. 6 (August 2019): 598–605. http://dx.doi.org/10.1177/1403494819851364.
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All political parties in Norway agree that social inequalities in health comprise a public health problem and should be reduced. Against this background, the Council on Social Inequalities in Health has taken action to provide specific advice to reduce social health differences. Our recommendations focus on the entire social gradient rather than just poverty and the socially disadvantaged. By proposing action on the social determinants of health such as affordable child-care, education, living environments and income structures, we aim to facilitate a possible re-orientation of policy away from redistribution to universalism. The striking challenges of the causes of health differences are complex, and the 29 recommendations to combat social inequality of health demand cross sectorial actions. The recommendations are listed thematically and have not been prioritized. Some are fundamental and require pronounced changes across sectors, whereas others are minor and sector-specific.
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Good, Kenneth. "At the Ends of the Ladder: Radical Inequalities in Botswana." Journal of Modern African Studies 31, no. 2 (June 1993): 203–30. http://dx.doi.org/10.1017/s0022278x00011903.
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Botswana ranks very high in sub-Saharan Africa in income per capita, and in such indicators of human development as public expenditure on health and education. Nevertheless, inequalities of wealth and income are particularly severe, in both international and domestic comparisons. Although wealth and poverty are mediated and expressed in complex ways, the disparities between the very rich and the very poor are established, structured, and growing.
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Curry, Chris, Liesl Zuhlke, Ana Mocumbi, and Neil Kennedy. "Acquired heart disease in low-income and middle-income countries." Archives of Disease in Childhood 103, no. 1 (August 24, 2017): 73–77. http://dx.doi.org/10.1136/archdischild-2016-312521.
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The burden of illness associated with acquired cardiac disease in children in low-income and middle-income countries (LMIC) is significant and may be equivalent to that of congenital heart disease. Rheumatic heart disease, endomyocardial fibrosis, cardiomyopathy (including HIV cardiomyopathy) and tuberculosis are the most important causes. All are associated with poverty with the neediest children having the least access to care. The associated mortality and morbidity is high. There is an urgent need to improve cardiac care in LMIC, particularly in sub-Saharan Africa and parts of Southeast Asia where the burden is highest.
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Sreeramareddy, Chandrashekhar T., Sam Harper, and Linda Ernstsen. "Educational and wealth inequalities in tobacco use among men and women in 54 low-income and middle-income countries." Tobacco Control 27, no. 1 (November 24, 2016): 26–34. http://dx.doi.org/10.1136/tobaccocontrol-2016-053266.
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BackgroundSocioeconomic differentials of tobacco smoking in high-income countries are well described. However, studies to support health policies and place monitoring systems to tackle socioeconomic inequalities in smoking and smokeless tobacco use common in low-and-middle-income countries (LMICs) are seldom reported. We aimed to describe, sex-wise, educational and wealth-related inequalities in tobacco use in LMICs.MethodsWe analysed Demographic and Health Survey data on tobacco use collected from large nationally representative samples of men and women in 54 LMICs. We estimated the weighted prevalence of any current tobacco use (including smokeless tobacco) in each country for 4 educational groups and 4 wealth groups. We calculated absolute and relative measures of inequality, that is, the slope index of inequality (SII) and relative index of inequality (RII), which take into account the distribution of prevalence across all education and wealth groups and account for population size. We also calculated the aggregate SII and RII for low-income (LIC), lower-middle-income (lMIC) and upper-middle-income (uMIC) countries as per World Bank classification.FindingsMale tobacco use was highest in Bangladesh (70.3%) and lowest in Sao Tome (7.4%), whereas female tobacco use was highest in Madagascar (21%) and lowest in Tajikistan (0.22%). Among men, educational inequalities varied widely between countries, but aggregate RII and SII showed an inverse trend by country wealth groups. RII was 3.61 (95% CI 2.83 to 4.61) in LICs, 1.99 (95% CI 1.66 to 2.38) in lMIC and 1.82 (95% CI 1.24 to 2.67) in uMIC. Wealth inequalities among men varied less between countries, but RII and SII showed an inverse pattern where RII was 2.43 (95% CI 2.05 to 2.88) in LICs, 1.84 (95% CI 1.54 to 2.21) in lMICs and 1.67 (95% CI 1.15 to 2.42) in uMICs. For educational inequalities among women, the RII varied much more than SII varied between the countries, and the aggregate RII was 14.49 (95% CI 8.87 to 23.68) in LICs, 3.05 (95% CI 1.44 to 6.47) in lMIC and 1.58 (95% CI 0.33 to 7.56) in uMIC. Wealth inequalities among women showed a pattern similar to that of men: the RII was 5.88 (95% CI 3.91 to 8.85) in LICs, 1.76 (95% CI 0.80 to 3.85) in lMIC and 0.39 (95% CI 0.09 to 1.64) in uMIC. In contrast to men, among women, the SII was pro-rich (higher smoking among the more advantaged) in 13 of the 52 countries (7 of 23 lMIC and 5 of 7 uMIC).InterpretationOur results confirm that socioeconomic inequalities tobacco use exist in LMIC, varied widely between the countries and were much wider in the lowest income countries. These findings are important for better understanding and tackling of socioeconomic inequalities in health in LMIC.
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Austin, Michael J., and Kathy Lemon. "Promising Programs to Serve Low-Income Families in Poverty Neighborhoods." Journal of Health & Social Policy 21, no. 1 (November 2005): 65–94. http://dx.doi.org/10.1300/j045v21n01_03.
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Carlsen, Lars, and Rainer Bruggemann. "Inequalities in the European Union—A Partial Order Analysis of the Main Indicators." Sustainability 13, no. 11 (June 2, 2021): 6278. http://dx.doi.org/10.3390/su13116278.
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The inequality within the 27 European member states has been studied. Six indicators proclaimed by Eurostat to be the main indicators charactere the countries: (i) the relative median at-risk-of-poverty gap, (ii) the income distribution, (iii) the income share of the bottom 40% of the population, (iv) the purchasing power adjusted GDP per capita, (v) the adjusted gross disposable income of households per capita and (vi) the asylum applications by state of procedure. The resulting multi-indicator system was analyzed applying partial ordering methodology, i.e., including all indicators simultaneously without any pretreatment. The degree of inequality was studied for the years 2010, 2015 and 2019. The EU member states were partially ordered and ranked. For all three years Luxembourg, The Netherlands, Austria, and Finland are found to be highly ranked, i.e., having rather low inequality. Bulgaria and Romania are, on the other hand, for all three years ranked low, with the highest degree of inequality. Excluding the asylum indicator, the risk-poverty-gap and the adjusted gross disposable income were found as the most important indicators. If, however, the asylum application is included, this indicator turns out as the most important for the mutual ranking of the countries. A set of additional indicators was studied disclosing the educational aspect as of major importance to achieve equality. Special partial ordering tools were applied to study the role of the single indicators, e.g., in relation to elucidate the incomparability of some countries to all other countries within the union.
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Bote, David, and Stephen Mago. "Health microinsurance in Zimbabwe: a contexual review." 11th GLOBAL CONFERENCE ON BUSINESS AND SOCIAL SCIENCES 11, no. 1 (December 9, 2020): 166. http://dx.doi.org/10.35609/gcbssproceeding.2020.11(166).
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Health microinsurance, a relatively novel financial product, is garnering increasing recognition as an important part of the solution to healthcare financing problems and poverty reduction efforts for low income households (World Health Organisation [WHO], 2000; Murdoch, 2004; Cohen and Sebstad, 2005; Churchill, 2006; Dror, 2006; International Labour Organisation [ILO], 2008; Ruuskanen, 2009). The adverse implications of health shocks and the consequent huge expenditures disproportionately impoverish millions of low-income households across the globe, especially those living in developing countries. Put bluntly, health risks are an enduring poverty reduction and development challenge at large. In fact, World Bank (2010) reports that more than 100 million people are driven into poverty every year by health-related costs across the globe (as cited in Mosley, 2009). Regardless of microinsurance's acclaimed benefits in securing the lives of low-income people, its potential to secure poor households is yet to be ascertained in Zimbabwe, where the poor are extremely vulnerable to fall and be entrapped in poverty, a monumental development challenge to this country. Keywords: Health insurance, health financing, health costs, Zimbabwe.
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Wagle, Udaya R. "How much do social protections matter to poverty and inequality? An insight from Asian experiences." Global Social Policy 17, no. 2 (November 29, 2016): 137–67. http://dx.doi.org/10.1177/1468018116675496.
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This article examines Asia’s experiences with social protection policies and their efficacy in addressing poverty and inequality. While the relatively high efficacy of the comprehensive welfare states of high-income countries has been widely documented, the experience of low- and middle-income countries may vary given the limited redistributive capacity of their social transfer. Data on 33 Asian countries covering 1990–2012 suggest that the limited and evolving composition and coverage of social protection policies vary significantly across countries and regions. Various panel data regressions estimated here yield significant roles of social protection policies in reducing inequality and especially poverty and extreme poverty even after controlling for the roles of gross domestic product (GDP) and other political economy, regional, and population characteristics. This analysis finds that the efficacy of evolving social protection policies from Asian countries does not vary significantly from those of more established welfare states. Whereas the aggregate level data on public social transfer expenditures are far from perfect and do not detail the qualitative variations in policy design and implementation, findings from this analysis help fill the void in literature to understand the degree to which low- and middle-income countries may count on social protection policies to address persistent poverty and growing inequalities.
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Chakraborty, Shankha, Chris Papageorgiou, and Fidel Pérez Sebastián. "HEALTH CYCLES AND HEALTH TRANSITIONS." Macroeconomic Dynamics 20, no. 1 (June 4, 2014): 189–213. http://dx.doi.org/10.1017/s1365100514000297.
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We study the dynamics of poverty and health in a model of endogenous growth and rational health behavior. Population health depends on the prevalence of infectious diseases that can be avoided through costly prevention. The incentive to do so comes from the negative effects of ill health on the quality and quantity of life. The model can generate a poverty trap where infectious diseases cycle between high and low prevalence. These cycles originate from the rationality of preventive behavior in contrast to the predator–prey dynamics of epidemiological models. We calibrate the model to reflect sub-Saharan Africa's recent economic recovery and analyze policy alternatives. Unconditional transfers are found to improve welfare relative to conditional health-based transfers: at low income levels, income growth (quality of life) is valued more than improvements to health (quantity of life).
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Nguyen, Nguyenvu, Juan Leon-Wyss, Krishna S. Iyer, and A. Thomas Pezzella. "Paediatric cardiac surgery in low-income and middle-income countries: a continuing challenge." Archives of Disease in Childhood 100, no. 12 (September 10, 2015): 1156–59. http://dx.doi.org/10.1136/archdischild-2015-308173.
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Despite advances in surgical and catheter-based treatment for congenital heart disease (CHD), there remain wide disparities across the globe. Ongoing international humanitarian and in-country programmes are working to address these issues with the ultimate goal to increase the quality and quantity of paediatric cardiac care, particularly in under-served regions of the world. This review aims to illustrate the reasons for these inequalities and suggests novel ways of improving access and sustainability of CHD programmes in low-income and middle-income countries.
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Guarnizo-Herreño, Carol C., Richard G. Watt, Nathaly Garzón-Orjuela, Elizabeth Suárez-Zúñiga, and Georgios Tsakos. "Health insurance and education: major contributors to oral health inequalities in Colombia." Journal of Epidemiology and Community Health 73, no. 8 (May 16, 2019): 737–44. http://dx.doi.org/10.1136/jech-2018-212049.
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BackgroundHealth inequalities, including inequalities in oral health, are problems of social injustice worldwide. Evidence on this issue from low-income and middle-income countries is still needed. We aimed to examine the relationship between oral health and different dimensions of socioeconomic position (SEP) in Colombia, a very unequal society emerging from a long-lasting internal armed conflict.MethodsUsing data from the last Colombian Oral Health Survey (2014), we analysed inequalities in severe untreated caries (≥3 teeth), edentulousness (total tooth loss) and number of missing teeth. Inequalities by education, income, area-level SEP and health insurance scheme were estimated by the relative index of inequality and slope index of inequality (RII and SII, respectively).ResultsA general pattern of social gradients was observed and significant inequalities for all outcomes and SEP indicators were identified with RII and SII. Relative inequalities were larger for decay by health insurance scheme, with worse decay levels among the uninsured (RII: 2.57; 95% CI 2.11 to 3.13), and in edentulousness (RII: 3.23; 95% CI 1.88 to 5.55) and number of missing teeth (RII: 2.08; 95% CI 1.86 to 2.33) by education, with worse levels of these outcomes among the lower educated groups. Absolute inequalities followed the same pattern. Inequalities were larger in urban areas.ConclusionHealth insurance and education appear to be the main contributors to oral health inequalities in Colombia, posing challenges for designing public health strategies and social policies. Tackling health inequalities is crucial for a fairer society in a Colombian post-conflict era and our findings highlight the importance of investing in education policies and universal health care coverage.