Journal articles: 'Social inequalities in health and health behaviour'

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Burkert, Nathalie, Éva Rásky, and Wolfgang Freidl. "Social inequalities regarding health and health behaviour in Austrian adults." Wiener klinische Wochenschrift 124, no. 7-8 (April 2012): 256–61. http://dx.doi.org/10.1007/s00508-012-0164-7.

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Pearce, Jamie, Ross Barnett, and Graham Moon. "Sociospatial inequalities in health-related behaviours." Progress in Human Geography 36, no. 1 (July 4, 2011): 3–24. http://dx.doi.org/10.1177/0309132511402710.

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There has been a resurgence of interest in how the social, built and cultural environments contribute to shaping health outcomes. The pathways relating place to health behaviour have received less attention. We develop a nuanced understanding of the pathways linking individuals, places and smoking. Two key pathways operate: place-based ‘practices’ and place-based ‘regulation’. Future geographical research should pay attention to the different scale effects, encompass a wider set of influences which affect the liveability and social composition of neighbourhoods, and specify group differences in the impact of the local economic and social environment upon smoking.

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McCarthy, Mark. "Urban development and health inequalities." Scandinavian Journal of Public Health 30, no. 59_suppl (September 2002): 59–62. http://dx.doi.org/10.1177/14034948020300031001.

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Urban development has historically been seen as both a cause and solution for social inequalities in health. However, environmental and individual gradients within urban areas occur everywhere, and are resistant to change. Environments are infl uenced by the degree and type of industrialization, quality of housing, accessibility to green space and - of increasing concern - transport. Individual behaviour, however, also contributes to social differences, both through migration and by the effects on individuals of cultural experiences through the life-course. Reduction on inequalities may be possible through larger social action, for example urban regeneration. There remains an important role for public health in addressing determinants of health at the population level.

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Sheiham, A., D. Alexander, L. Cohen, V. Marinho, S. Moysés, P. E. Petersen, J. Spencer, R. G. Watt, and R. Weyant. "Global Oral Health Inequalities." Advances in Dental Research 23, no. 2 (April 13, 2011): 259–67. http://dx.doi.org/10.1177/0022034511402084.

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This paper reviews the shortcomings of present approaches to reduce oral diseases and inequalities, details the importance of social determinants, and links that to research needs and policies on implementation of strategies to reduce oral health inequalities. Inequalities in health are not narrowing. Attention is therefore being directed at determinants of major health conditions and the extent to which those common determinants vary within, between, and among groups, because if inequalities in health vary across groups, then so must underlying causes. Tackling inequalities in health requires strategies tailored to determinants and needs of each group along the social gradient. Approaches focusing mainly on downstream lifestyle and behavioral factors have limited success in reducing health inequalities. They fail to address social determinants, for changing people’s behaviors requires changing their environment. There is a dearth of oral health research on social determinants that cause health-compromising behaviors and on risk factors common to some chronic diseases. The gap between what is known and implemented by other health disciplines and the dental fraternity needs addressing. To re-orient oral health research, practice, and policy toward a ‘social determinants’ model, a closer collaboration between and integration of dental and general health research is needed. Here, we suggest a research agenda that should lead to reductions in global inequalities in oral health.

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Haynes, Robin, Espen Dahl, and Britt Dale. "Geographical and Social Inequalities in Health and Health Behaviour in the Nord-Trøndelag Health Study (HUNT)." Norsk Geografisk Tidsskrift - Norwegian Journal of Geography 65, no. 2 (June 2011): 115–16. http://dx.doi.org/10.1080/00291951.2011.574380.

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Kooiker, Sjoerd, and Terkel Christiansen. "Inequalities in health: the interaction of circumstances and health related behaviour." Sociology of Health and Illness 17, no. 4 (September 1995): 495–524. http://dx.doi.org/10.1111/1467-9566.ep10932690.

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Bastos, Tássia Fraga, Maria Cecília Goi Porto Alves, Marilisa Berti de Azevedo Barros, and Chester Luiz Galvão Cesar. "Men's health: a population-based study on social inequalities." Cadernos de Saúde Pública 28, no. 11 (November 2012): 2133–42. http://dx.doi.org/10.1590/s0102-311x2012001100013.

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This study evaluates social inequalities in health according to level of schooling in the male population. This was a cross-sectional, population-based study with a sample of 449 men ranging from 20 to 59 years of age and living in Campinas, São Paulo State, Brazil. The chi-square test was used to verify associations, and a Poisson regression model was used to estimate crude and adjusted prevalence ratios. Men with less schooling showed higher rates of alcohol consumption and dependence, smoking, sedentary lifestyle during leisure time, and less healthy eating habits, in addition to higher prevalence of bad or very bad self-rated health, at least one chronic disease, hypertension, and other health problems. No differences were detected between the two schooling strata in terms of use of health services, except for dental services. The findings point to social inequality in health-related behaviors and in some health status indicators. However, possible equity was observed in the use of nearly all types of health services.

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van Lenthe, Frank J., Pekka Martikainen, and Johan P. Mackenbach. "Neighbourhood inequalities in health and health-related behaviour: Results of selective migration?" Health & Place 13, no. 1 (March 2007): 123–37. http://dx.doi.org/10.1016/j.healthplace.2005.09.013.

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Borrell, C. "Social inequalities in health related behaviours in Barcelona." Journal of Epidemiology & Community Health 54, no. 1 (January 1, 2000): 24–30. http://dx.doi.org/10.1136/jech.54.1.24.

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Barros, Marilisa Berti de Azevedo, Priscila Maria Stolses Bergamo Francisco, Margareth Guimarães Lima, and Chester Luiz Galvão César. "Social inequalities in health among the elderly." Cadernos de Saúde Pública 27, suppl 2 (2011): s198—s208. http://dx.doi.org/10.1590/s0102-311x2011001400008.

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The aim of the present study was to assess social inequalities in health status, health behavior and the use of health services based on education level. A population-based cross-sectional study was carried out involving 1,518 elderly residents of Campinas, São Paulo State, Brazil. Significant demographic and social differences were found between schooling strata. Elderly individuals with a higher degree of schooling are in greater proportion alcohol drinkers, physically active, have healthier diets and a lower prevalence of hypertension, diabetes, dizziness, headaches, back pain, visual impairment and denture use, and better self-rated health. But, there were no differences in the use of health services in the previous two weeks, in hospitalizations or surgeries in the previous year, nor in medicine intake over the previous three days. Among elderly people with hypertension and diabetes, there were no differences in the regular use of health services and medication. The results demonstrate social inequalities in different health indicators, along with equity in access to some health service components.

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Arifin, Hadi Suprapto, Ditha Prasanti, and Ikhsan Fuady. "Communicating Inequalities: Social Disparity Phenomena in Health." E3S Web of Conferences 73 (2018): 11001. http://dx.doi.org/10.1051/e3sconf/20187311001.

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The phenomenon of HIV and AIDS has evolved into one of the most endless issues of health and social issues in the world, thereby becoming an agenda in the Suistanable Development Goals (SDG’s) Indonesia until this year. Like the iceberg phenomenon, the problem of HIV AIDS is a contemporary issue related to human risk behavior, not just about health problems, but also about the social problems of one’s relationship with the environment. This is what triggered the emergence of social disparity in the tourist area of Pangandaran. The latest data shows Pangandaran as one of the highest areas of HIV AIDS infections. In reality, there is still a gap or disparity between geographic regions, population groups, and socioeconomic levels. Therefore, authors want to know the efforts of local government in highlighting cases of social disparity for HIV AIDS infections in the tourist area Pangandaran. The result of the research shows that there is still a social disparity phenomenon for people living wih HIV AIDS (ODHA) in Pangandaran tourism area, mainly related to 1) Facilitation of health services; 2) HIV AIDS epidemic and; 3) Availability of trained human resources to serve ODHA in Pangandaran. In this case, the local government continues to work and coordinate with various parties, communities, including NGOs of the Matahati Foundation and AHF (AIDS Health Care Foundation) to minimize social disparities for people living with HIV AIDS (ODHA) in Pangandaran.

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Bayram, Tevfik, and Milka Donchin. "Determinants of health behavior inequalities: a cross-sectional study from Israel." Health Promotion International 34, no. 5 (July 16, 2018): 941–52. http://dx.doi.org/10.1093/heapro/day054.

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Summary Health behaviors are shaped by the opportunities people have; and the choices they make according to these opportunities. Inequality in economic, cultural and social resources causes disparities in health and health behaviors. Jerusalem has a multiethnic structure, mainly made up of Jews and Arabs. Arabs and Ultra-Orthodox Jews are disadvantaged in terms of socio-economic and health indicators. The purpose of this study is to determine the factors associated with three health behaviors: physical activity (PA), fruit and vegetable consumption, and smoking. This cross-sectional study was conducted among 1682 adults from a stratified sample by age, sex and neighborhood from 2011 to 2015, in accordance with the Healthy Cities project. Univariate analyses were conducted by Chi-square test of independence; and multivariate analyses by logistic regression models. Of the total population, 12% do adequate amounts of PA; 17.6% consume adequate amounts of fruits/vegetables; and 19.4% are current smokers. Multivariate analyses indicates for both genders: ethnicity/religion and education level is associated with doing PA; ethnicity/religion, education and income level is associated with fruit/vegetable consumption; and ethnicity/religion, and age is associated with smoking. However, gender significantly modifies the effect of ethnicity/religion for all the three health behaviors. Gender disparities regarding health behaviors are higher among Arabs and Ultra-Orthodox Jews. In similar economic, cultural and social circumstances, men and women have similar health behaviors; and unequal opportunity to education and income creates a vicious gender inequality cycle. Therefore, to reduce health behavior inequalities, besides economic and cultural inequalities, social and gender inequalities should also be reduced.

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Stansfield, Jude, and Ruth Bell. "Applying a psychosocial pathways model to improving mental health and reducing health inequalities: Practical approaches." International Journal of Social Psychiatry 65, no. 2 (January 17, 2019): 107–13. http://dx.doi.org/10.1177/0020764018823816.

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Background: Mental health can help explain how social inequalities impact on health. Many current public health challenges are shaped by social, economic and environmental conditions that take a mental toll on society. Purpose: This article describes a conceptual framework illustrating the psychosocial pathways that link the wider conditions to health behaviours and outcomes. It draws out implications of this framework for mental health practice that aim to support policy and decision-making on future action to reduce health inequalities and presents practical examples of what can be done. Methods: This article expands on a report commissioned by Public Health England. A narrative review and synthesis of relevant evidence built on existing research by the Institute of Health Equity. A conceptual framework was developed and a consultation exercise with stakeholders helped to revise and illustrate it with practice examples. Conclusions: The field of mental health has much to contribute to prevention, not just of mental illness but also of physical health conditions and reduction of inequalities in life expectancy and healthy life expectancy, especially through collaborative public health action.

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Sointu, Eeva. "Challenges and a Super Power: How Medical Students Understand and Would Improve Health in Neoliberal Times." Critical Sociology 46, no. 6 (November 13, 2019): 851–65. http://dx.doi.org/10.1177/0896920519880242.

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Even though much research underscores the significance of social inequalities in illness, the health consequences of inequity tend to occupy a marginal position in medical education. Drawing on qualitative interviews with third and fourth year medical students, this paper explores how future doctors understand and would improve health in the United States. While participants with background in public health and policy understand that social inequalities shape health and access to care, many others emphasize individual behaviour and motivation as central to ill health. Emphasizing health behaviour aligns with biomedical understandings of disease, and also captures the hold of neoliberal values over ideas of health and illness. Focus on health behaviour also provides a means of ignoring the racist roots of enduring inequity that underlies much ill health. Making inequity more visible in medical education and practice necessitates recognizing the sway of neoliberal thought over common-sense ideas of health and illness.

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Bastos, J. L., R. K. Celeste, and Y. C. Paradies. "Racial Inequalities in Oral Health." Journal of Dental Research 97, no. 8 (April 10, 2018): 878–86. http://dx.doi.org/10.1177/0022034518768536.

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Together with other social categories, race has been at the core of much scholarly work in the area of humanities and social sciences, as well as a host of applied disciplines. In dentistry, debates have ranged from the use of race as a criterion for the recommendation of specific dental procedures to a means of assessing inequalities in a variety of outcomes. What is missing in these previous discussions, though, is a broader understanding of race that transcends relations with genetic makeup and other individual-level characteristics. In this review, we provide readers with a critique of the existing knowledge on race and oral health by answering the following 3 guiding questions: (1) What concepts and ideas are connected with race in the field of dentistry? (2) What can be learned and what is absent from the existing literature on the topic? (3) How can we enhance research and policy on racial inequalities in oral health? Taken together, the reviewed studies rely either on biological distinctions between racial categories or on other individual characteristics that may underlie racial disparities in oral health. Amidst a range of individual-level factors, racial inequalities have often been attributed to lower socioeconomic status and “health-damaging” cultural traits, for instance, patterns of and reasons for dental visits, dietary habits, and oral hygiene behaviors. While this literature has been useful in documenting large and persistent racial gaps in oral health, wider sociohistorical processes, such as systemic racism, as well as their relationships with economic exploitation, social stigmatization, and political marginalization, have yet to be operationalized among studies on the topic. A nascent body of research has recently begun to address some of these factors, but limited attention to structural theories of racism means that many more studies are needed to effectively mitigate racial health differentials.

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Mollborn, Stefanie, Elizabeth M. Lawrence, and Jarron M. Saint Onge. "Contributions and Challenges in Health Lifestyles Research." Journal of Health and Social Behavior 62, no. 3 (September 2021): 388–403. http://dx.doi.org/10.1177/0022146521997813.

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The concept of health lifestyles is moving scholarship beyond individual health behaviors to integrated bundles of behaviors undergirded by group-based identities and norms. Health lifestyles research merges structure with agency, individual-level processes with group-level processes, and multifaceted behaviors with norms and identities, shedding light on why health behaviors persist or change and on the reproduction of health disparities and other social inequalities. Recent contributions have applied new methods and life course perspectives, articulating health lifestyles’s dynamic relationships to social contexts and demonstrating their implications for health and development. Culturally focused work has shown how health lifestyles function as signals for status and identity and perpetuate inequalities. We synthesize literature to articulate recent advances and challenges and demonstrate how health lifestyles research can strengthen health policies and inform scholarship on inequalities. Future work emphasizing health lifestyles’s collective nature and attending to upstream social structures will further elucidate complex social processes.

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Hsieh, Ning, and Stef M. Shuster. "Health and Health Care of Sexual and Gender Minorities." Journal of Health and Social Behavior 62, no. 3 (September 2021): 318–33. http://dx.doi.org/10.1177/00221465211016436.

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Research on the social dimensions of health and health care among sexual and gender minorities (SGMs) has grown rapidly in the last two decades. However, a comprehensive review of the extant interdisciplinary scholarship on SGM health has yet to be written. In response, we offer a synthesis of recent scholarship. We discuss major empirical findings and theoretical implications of health care utilization, barriers to care, health behaviors, and health outcomes, which demonstrate how SGMs continue to experience structural- and interactional-level inequalities across health and medicine. Within this synthesis, we also consider the conceptual and methodological limitations that continue to beleaguer the field and offer suggestions for several promising directions for future research and theory building. SGM health bridges the scholarly interests in social and health sciences and contributes to broader sociological concerns regarding the persistence of sexuality- and gender-based inequalities.

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Heard, Emma, Lisa Fitzgerald, Britta Wigginton, and Allyson Mutch. "Applying intersectionality theory in health promotion research and practice." Health Promotion International 35, no. 4 (August 7, 2019): 866–76. http://dx.doi.org/10.1093/heapro/daz080.

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Abstract Health promotion researchers and practitioners are grappling with how to address growing health inequalities for population groups. In particular, critiques of dominant behaviour change approaches draw attention to the need to engage with social theories to better understand the social and relational drivers of health. Public health researchers are increasingly acknowledging intersectionality as an important theoretical approach, providing a framework for investigating health inequalities by highlighting intersections of individuals’ multiple identities within social systems of power that compound and exacerbate experiences of ill health. This article provides an overview of the diverse ways public health researchers and practitioners have applied intersectionality theory to better understand and address health inequalities. We map three key applications of intersectionality theory in public health: as an epistemological approach, as a methodological approach, and as a tool for action and intervention. Drawing on this work, we argue that health promotion researchers and practitioners can enhance engagement with intersectionality theory to address important challenges within the field. Through this article, we aim to inspire the continued exploration of intersectionality and offer some insights into opportunities and challenges for doing so in health promotion.

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Bonizzato, Paola, and Juan Eduardo Tello. "Social economic inequalities and mental health. I. Concepts, theories and interpretations." Epidemiologia e Psichiatria Sociale 12, no. 3 (September 2003): 205–18. http://dx.doi.org/10.1017/s1121189x00002980.

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SummaryAims – Reconstructing the models used for approaching the inequalities issues in health, idenfiying the most relevant theoretical and conceptual contributions. Method – Literature electronic-search on Medline, Psyclit, Econlit, Social Science Index and SocioSearch using the key-words inequalities, deprivation, poverty, socio-economic status, social class, occupational class, mental health for the period 1965-2002; integrated with manual search. The material was classified according to the conceptual and theoretical interpretative models or to the analyses of the association 'inequalities-health' where health was expressed as mortality, morbidity or services utilisation. Results – Four different interpretative models about the genesis of inequalities were identified. Further theoretical developments overcome the distinction among conceptuals contrapositions selection versus causation, statistic artefactual versus real differences, individual behaviours versus material context. Since the 80's the concept of material deprivation has been enlarged to include social deprivation to explain health inequalities. The social exclusion is related to material deprivation and to social fragility enlarging the traditional aspects of poverty. The theories that better adapt to the psychiatric field are the social selection and social causation. Conclusions – The social exclusion and the new methodologies for measuring the inequalities seems to be an effective way for understanding of the inexplored aspects of the mental health inequalities.Declaration of Interest: This work was partly funded by the Department of the Public Health Sciences “G. Sanarelli” of the University of Rome “La Sapienza” and the Department of Medicine and Public Health of the University of Verona.

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González-Rábago, Yolanda, Andrea Cabezas-Rodríguez, and Unai Martín. "Social Inequalities in Health Determinants in Spanish Children during the COVID-19 Lockdown." International Journal of Environmental Research and Public Health 18, no. 8 (April 13, 2021): 4087. http://dx.doi.org/10.3390/ijerph18084087.

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The COVID-19 lockdown was imposed in a context of notable inequalities in the distribution of the social determinants of health. It is possible that the housing conditions in which children and their families experienced the confinement, and the adoption of healthy behaviors, may have followed unequal patterns. The aim was to describe social inequalities in housing conditions and in health-related behaviors among children during the lockdown in Spain. This cross-sectional study was based on data from an online survey collecting information on the child population (3–12 years) living in Spain (n = 10,765). The outcome variables used were several housing conditions and health-related behaviors. The socioeconomic variables used were financial difficulties and parents’ educational level. Crude prevalence and prevalence ratios estimated using Poisson models were calculated. During lockdown, children from families with low educational levels and financial difficulties not only tended to live in poor housing conditions, but were also exposed to negative health determinants such as noise and tobacco smoke; they took less physical exercise, had a poorer diet, spent more time in front of screens and had less social contact. A notable social gradient was found in most of the variables analyzed. The results point to the need to incorporate the perspective of equity in the adoption of policies in order to avoid the increase of pre-existing social inequalities in the context of a pandemic.

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McGloin, Aileen F., and Sara Eslami. "Digital and social media opportunities for dietary behaviour change." Proceedings of the Nutrition Society 74, no. 2 (October 16, 2014): 139–48. http://dx.doi.org/10.1017/s0029665114001505.

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The way that people communicate, consume media and seek and receive information is changing. Forty per cent of the world's population now has an internet connection, the average global social media penetration is 39 % and 1·5 billion people have internet access via mobile phone. This large-scale move in population use of digital, social and mobile media presents an unprecedented opportunity to connect with individuals on issues concerning health. The present paper aims to investigate these opportunities in relation to dietary behaviour change. Several aspects of the digital environment could support behaviour change efforts, including reach, engagement, research, segmentation, accessibility and potential to build credibility, trust, collaboration and advocacy. There are opportunities to influence behaviour online using similar techniques to traditional health promotion programmes; to positively affect health-related knowledge, skills and self-efficacy. The abundance of data on citizens’ digital behaviours, whether through search behaviour, global positioning system tracking, or via demographics and interests captured through social media profiles, offer exciting opportunities for effectively targeting relevant health messages. The digital environment presents great possibilities but also great challenges. Digital communication is uncontrolled, multi-way and co-created and concerns remain in relation to inequalities, privacy, misinformation and lack of evaluation. Although web-based, social-media-based and mobile-based studies tend to show positive results for dietary behaviour change, methodologies have yet to be developed that go beyond basic evaluation criteria and move towards true measures of behaviour change. Novel approaches are necessary both in the digital promotion of behaviour change and in its measurement.

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Goy, Jennifer, Mark W. Rosenberg, and Will D. King. "Health Risk Behaviors: Examining Social Inequalities in Bladder and Colorectal Cancers." Annals of Epidemiology 18, no. 2 (February 2008): 156–62. http://dx.doi.org/10.1016/j.annepidem.2007.09.004.

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Miltiade, Stanciu. "Education-Healthy Development Binomial from the Health of Whole Living Entity Perspective." International Journal of Sustainable Economies Management 4, no. 3 (July 2015): 28–35. http://dx.doi.org/10.4018/ijsem.2015070103.

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Social life including economic life should evolve in harmony with live world ecology. The economy, as human society product should harmonize with the exigencies of “the health of whole living entity”. However, the realities of the present lived at local and global level reveal: inhuman social inequalities, frustrating consumerism, systemic pollution, poverty in the middle abundance, science without humanism, wealth without honest work etc. generated by negative human behaviors. The transition towards healthy development defined by the win-win principle, assumes that everything healthy for the natural environment is also healthy for man-created environment. This complex and long process is based on the re-spiritualization of the current educational model based on skills with the educational model in the cause of life.

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Moor, Irene, Thomas Lampert, Katharina Rathmann, Benjamin Kuntz, Petra Kolip, Jacob Spallek, and Matthias Richter. "Explaining educational inequalities in adolescent life satisfaction: do health behaviour and gender matter?" International Journal of Public Health 59, no. 2 (December 25, 2013): 309–17. http://dx.doi.org/10.1007/s00038-013-0531-9.

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Gibney, Sarah, Lucy Bruton, Catherine Ryan, Gerardine Doyle, and Gillian Rowlands. "Increasing Health Literacy May Reduce Health Inequalities: Evidence from a National Population Survey in Ireland." International Journal of Environmental Research and Public Health 17, no. 16 (August 13, 2020): 5891. http://dx.doi.org/10.3390/ijerph17165891.

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Background. Health literacy has been separately associated with socio-economic status and worse health status and outcomes. However, the magnitude of the associations between health literacy and health status and outcomes may not be evenly distributed across society. This study aims to estimate and compare the associations between health status, health behaviours, and healthcare utilisation within different levels of social status in the Irish population. Materials and methods. Data from Ireland collected as part of the 2011 European Health Literacy Survey were analysed. General health literacy was measured on a 0–50 scale, low to high. There were four binary outcomes: long-standing health conditions, smoking, hospital visits in the last 12 months, and self-rated health status. Logistic regression analysis was conducted to estimate the likelihood of each health outcome. Health literacy was treated as the main independent variable. Marginal effects were calculated using the delta method to demonstrate the change in likelihood of each outcome associated with a 5-point increase in health literacy score. The sample was grouped into tertiles based on self-reported social status, and models were replicated and compared for each tertile. Models were adjusted for known correlates of health literacy and health: age, gender, and education. Analysis was conducted using Stata V14. Results. Higher health literacy scores were associated with a lower probability of having a limiting illness within the low social status group only. Higher health literacy scores were associated with a lower probability of three or more hospital visits in the past 12 months in the low and middle social status groups. For people in the low and middle social status groups, higher health literacy levels were associated with a lower probability of being a current smoker. The associations between health literacy and self-rated health status were similar in each social status group. Conclusions: Improvement in population health literacy may reduce the prevalence of long-term chronic health conditions, reduce smoking levels, and result in fewer hospital visits. Whilst improved health literacy should improve behaviours and outcomes in all groups, it should have a more marked impact in lower social status groups, and hence contribute to reducing the observed social disparities in these health outcomes.

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Link, Bruce G., and San Juanita García. "Diversions: How the Underrepresentation of Research on Advantaged Groups Leaves Explanations for Health Inequalities Incomplete." Journal of Health and Social Behavior 62, no. 3 (August 6, 2021): 334–49. http://dx.doi.org/10.1177/00221465211028152.

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We identify a gap in health inequalities research that sociologists are particularly well situated to fill—an underrepresentation of research on the role advantaged groups play in creating inequalities. We name the process that creates the imbalance health-inequality diversions. We gathered evidence from awarded grants (349), major health-related data sets (7), research articles (324), and Healthy People policy recommendations. We assess whether the inequality-generating actions of advantaged groups are considered either directly by capturing their behaviors or indirectly by asking disadvantaged people about discrimination or exploitation from advantaged groups. We further assess whether there is a tendency to locate the problem in the person or group experiencing health inequalities. We find that diversions are prevalent across all steps of the research process. The diversion concept suggests new lines of sociological research to understand why diversions occur and how gaps in evidence concerning the role of the advantaged might be filled.

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Oosterhoff, Marije, Manuela A. Joore, Nina H. M. Bartelink, Bjorn Winkens, Onno C. P. Schayck, and Hans Bosma. "Longitudinal analysis of health disparities in childhood." Archives of Disease in Childhood 104, no. 8 (April 4, 2019): 781–88. http://dx.doi.org/10.1136/archdischild-2018-316482.

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ObjectiveCombatting disparities in health outcomes among children is a major public health concern. This study focuses on two questions: (1) To what extent does socioeconomic status (SES) contribute to disparities in health outcomes? and (2) To what extent can social inequalities in health outcomes be explained by differences in children’s health behaviours?DesignThis study included 2-year follow-up data of 1259 children (4–12 years of age) who participated in the ‘Healthy Primary School of the Future’ project (ClinicalTrials.gov NCT02800616). SES was measured by maternal and paternal education and household income (adjusted for family size). Health outcomes were body mass index (BMI) z-score, health resource use, school absenteeism, health-related quality of life and psychosocial health, measured over 2 years of follow-up (2015–2017). Health behaviours included physical activity, and consumption of fruits, vegetables and sweetened beverages. Associations between SES and baseline health behaviours were examined, and mixed models for repeated measures were used to assess associations between SES and health outcomes over 2 years of follow-up.ResultsA high socioeconomic background was significantly associated with better health outcomes (all outcomes). For example, children with a low SES had higher BMI z-scores (beta coefficient: 0.42, 95% CI 0.22 to 0.62) and higher consumption healthcare costs (ratio of mean costs: 2.21, 95% CI 1.57 to 3.10). Effects of SES changed very little after controlling for health behaviours.DiscussionOur findings strongly suggest that socioeconomic background has a pervasive impact on disparities in child health, but gives little support to the idea that social inequalities in child health can be tackled by means of lifestyle interventions.

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Esquius, Laura, Alicia Aguilar-Martínez, Marina Bosque-Prous, Helena González-Casals, Anna Bach-Faig, Ester Colillas-Malet, Gemma Salvador, and Albert Espelt. "Social Inequalities in Breakfast Consumption among Adolescents in Spain: The DESKcohort Project." Nutrients 13, no. 8 (July 22, 2021): 2500. http://dx.doi.org/10.3390/nu13082500.

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Breakfast has a critical role in energy balance and dietary regulation. Consequently, it is considered an important component of a healthy diet, especially in adolescence, when there are great opportunities to consolidate habits and establish future patterns of healthiness in adulthood. Socioeconomic position (SEP) causes inequalities that are reflected in health behaviors, physical activity, mental health, and diet. Therefore, we conducted a cross-sectional study using data from the 2019–2020 DESKcohort project (Spain) to explore the relationships between breakfast and sociodemographic characteristics, health-related behaviors, and school performance of 7319 adolescents. Our findings showed that the prevalence of skipping breakfast every day was 19.4% in girls and 13.7% in boys and was related to students’ SEP. The risk of skipping breakfast was 30% higher in girls from the most disadvantaged SEP, in comparison to those in the most advanced SEP (prevalence ratio (PR) = 1.30; 95% confidence interval (CI) = 1.11–1.54). Also, boys from the most disadvantaged SEP showed 28% higher risk of skipping breakfast than those in the most advanced SEP (PR = 1.28; 95% CI = 1.04–1.59). In conclusion, future public policies should be adapted considering a SEP and gender perspective to avoid increasing nutritional and health inequalities.

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Weaver, Raven H., Alexandra Jackson, Jane Lanigan, Thomas G. Power, Alana Anderson, Anne E. Cox, Linda Eddy, Louise Parker, Yoshie Sano, and Elizabeth Weybright. "Health Behaviors at the Onset of the COVID-19 Pandemic." American Journal of Health Behavior 45, no. 1 (January 1, 2021): 44–61. http://dx.doi.org/10.5993/ajhb.45.1.4.

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Objectives: We examined perceived behavior change since implementation of physical distancing restrictions and identified modifiable (self-rated health, resilience, depressive symptoms, social support and subjective wellbeing) and non-modifiable (demographics) risk/protective factors. Methods: A representative US sample (N = 362) completed an online survey about potential risk/protective factors and health behaviors prior to the pandemic and after implemented/recommended restrictions. We assessed change in perceived health behaviors prior to and following introduction of COVID-19. We conducted hierarchical linear regression to explore and identify risk/protective factors related to physical activity, diet quality, and social isolation. Results: There have been substantial decreases in physical activity and increases in sedentary behavior and social isolation, but no changes in diet quality since COVID-19. We identified modifiable and non-modifiable factors associated with each health behavior. Conclusions: Negative effects indicate the need for universal intervention to promote health behaviors. Inequalities in health behaviors among vulnerable populations may be exacerbated since COVID-19, suggesting need for targeted invention. Social support may be a mechanism to promote health behaviors. We suggest scaling out effective health behavior interventions with the same intensity in which physical distancing recommendations were implemented.

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Alvarez-Galvez, Javier. "Multidimensionality of Health Inequalities: A Cross-Country Identification of Health Clusters through Multivariate Classification Techniques." International Journal of Environmental Research and Public Health 15, no. 9 (September 1, 2018): 1900. http://dx.doi.org/10.3390/ijerph15091900.

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Despite major efforts in scientific literature to explain and understand the social determinants of health inequalities, the complex association between social causes and health outcomes remains empirically questionable and theoretically puzzling. To date, the studies on social determinants of health has mainly been generated by research techniques and methods that were developed to answer specific questions about the causes and effects of particular indicators on specific health outcomes. The present exploratory study follows a complex system approach to capture the interdependence between socioeconomic status, lifestyles, and health in a single measure that enables international comparisons of population health. Specifically, this study is aimed to: (a) classify individuals’ state of health according the usage of multidimensional data on physical and mental health, SES, lifestyles and risk behaviors, in order to (b) compare the relative strength of the different predictors of health groups (or clusters) at the individual-level and, finally, (c) to measure the level of health inequalities between different countries. From a complex system approach, this study uses multivariate classification methods to compare health groups in a sample of 29 countries and shows that interdependence models may be useful to describe and compare between-country health inequalities that are not visible through techniques for the analysis of dependence. The present work offers two fundamental contributions. On the one hand, this study compares the relative relevance of different indicators that are susceptible to affect individual health outcomes; on the other hand, the resulting multidimensional classification of countries according health clusters provides an alternative for inter-country health comparisons.

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Thebault, Jean-Laurent, Virginie Ringa, Géraldine Bloy, Isabelle Pendola-Luchel, Sylvain Paquet, Henri Panjo, Raphaëlle Delpech, et al. "Are primary-care physician practices related to health behaviors likely to reduce social inequalities in health?" Preventive Medicine 99 (June 2017): 21–28. http://dx.doi.org/10.1016/j.ypmed.2017.01.023.

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Torchyan, Armen A., and Hans Bosma. "Socioeconomic Inequalities in Health among Armenian Adolescents." International Journal of Environmental Research and Public Health 17, no. 11 (June 6, 2020): 4055. http://dx.doi.org/10.3390/ijerph17114055.

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We aimed to study the hypothesis of socioeconomic equalization in health among Armenian adolescents participating in the Health Behavior in School-Aged Children 2013/14 survey. Classes corresponding to the ages 11, 13, and 15 were selected using a clustered sampling design. Multiple logistic regression analyses were used. In a nationally representative sample of 3679 students, adolescents with a low family socioeconomic position (SEP) had greater odds of reporting less than good health (odds ratio (OR) = 2.81, 95% CI = 2.25–3.51), low psychosocial well-being (OR = 1.94, 95% CI = 1.44–2.61), or psychosomatic symptoms (OR = 1.29, 95% CI = 1.07–1.56). Low levels of material well-being were associated with a higher likelihood of reporting less than good health (OR = 1.32, 95% CI = 1.06–1.65) or low psychosocial well-being (OR = 1.27, 95% CI = 1.04–1.54). The presence of both risk factors had a synergistic effect on having low psychosocial well-being (P-interaction = 0.031). Refuting the equalization hypothesis, our results indicate that low SEP might be strongly related to adolescent health in middle-income countries such as Armenia. Low material well-being also proved important, and, for further research, we hypothesized an association via decreased peer social status and compromised popularity.

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García, San Juanita, Taylor Trummel, Monica Cornejo, Katherine Maldonado, Ana Ojeda, Humberto Flores, and Bruce G. Link. "Immigrant Health Inequities: Exposing Diversions and White Supremacy." Social Sciences 10, no. 9 (September 13, 2021): 341. http://dx.doi.org/10.3390/socsci10090341.

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Diversions occur when research disregards the inequality-generating actions of advantaged groups and instead focuses attention on the actions and behaviors of disadvantaged groups. We incorporate important insights from COVID-19 to illustrate historical and contemporary examples of diversions. This paper highlights US immigrant health inequities—a burgeoning subfield within the broader health inequalities canon—to explore: (1) if and how diversions appear in immigrant health studies; (2) how often white supremacy and intersectionality are explicitly named in grants, publicly available datasets, and published research. The data derive from: NIH R01 grants (17), publicly available datasets that focus on immigrant health (7), and research published in three health journals (14). Using a qualitative content analysis approach, we analyzed these data as evidence concerning the knowledge production cycle, and investigate whether: (a) the role of advantaged groups in generating inequalities is explicitly mentioned; (b) disadvantaged groups are asked about discriminatory actions perpetuated by advantaged groups; (c) health inequalities are placed on the conditions of disadvantaged groups; (d) if white supremacy and intersectionality are explicitly mentioned in grants, publicly available datasets, and research articles. The findings demonstrate the prevalence of diversions in immigrant health research, given an overemphasis on health behaviors and cultural explanations towards explaining immigrant health inequities. There was no mention of white supremacy across the knowledge production cycle. Intersectionality was mentioned once in a research article. We argue that understanding white supremacy’s role in the knowledge production cycle illuminates how diversions occur and prevail. We provide suggestions on moving away from diversionary research, toward adopting an intersectional approach of the study of immigrant health inequities.

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Elenbaas, Laura, Michael T. Rizzo, and Melanie Killen. "A Developmental-Science Perspective on Social Inequality." Current Directions in Psychological Science 29, no. 6 (November 18, 2020): 610–16. http://dx.doi.org/10.1177/0963721420964147.

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Many people believe in equality of opportunity but overlook and minimize the structural factors that shape social inequalities in the United States and around the world, such as systematic exclusion (e.g., educational, occupational) based on group membership (e.g., gender, race, socioeconomic status). As a result, social inequalities persist and place marginalized social groups at elevated risk for negative emotional, learning, and health outcomes. Where do the beliefs and behaviors that underlie social inequalities originate? Recent evidence from developmental science indicates that an awareness of social inequalities begins in childhood and that children seek to explain the underlying causes of the disparities that they observe and experience. Moreover, children and adolescents show early capacities for understanding and rectifying inequalities when regulating access to resources in peer contexts. Drawing on a social reasoning developmental framework, we synthesize what is currently known about children’s and adolescents’ awareness, beliefs, and behavior concerning social inequalities and highlight promising avenues by which developmental science can help reduce harmful assumptions and foster a more just society.

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Bell, Khan, Romeo-Velilla, Stegeman, Godfrey, Taylor, Morris, et al. "Ten Lessons for Good Practice for the INHERIT Triple Win: Health, Equity, and Environmental Sustainability." International Journal of Environmental Research and Public Health 16, no. 22 (November 17, 2019): 4546. http://dx.doi.org/10.3390/ijerph16224546.

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The world’s challenges of climate change, damage to ecosystems, and social and health inequalities require changes in human behaviours at every level of organisation, among governments, business, communities, and individuals. An important question is how behaviour change can be enabled and supported at the scale and speed required. The research reported in this paper describes important lessons for good practice in changing contexts to modify behaviours for a triple win for health, equity and environmental sustainability. Authors synthesised learning from qualitative, quantitative and cost benefit evaluations of 15 case studies conducted in 12 countries in Europe. The case studies address ways of living (green spaces and energy efficient housing), moving (active transport) and consuming (healthy and sustainable diets) that support the triple win. Ten lessons for good practice were identified. These include bringing a triple win mindset to policy and practice in planning interventions, with potential to improve environmental sustainability, health and equity at the same time. The lessons for good practice are intended to support governmental and non-governmental actors, practitioners and researchers planning to work across sectors to achieve mutual benefits for health and environmental sustainability and in particular to benefit poorer and more socio-economically disadvantaged groups.

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Soskolne, Varda, Michal Cohen-Dar, Samira Obeid, Nitsa Cohen, and Mary C. J. Rudolf. "Socio-Economic, Psychosocial, Lifestyle and Community Factors do not Explain Ethnic Inequalities in Obesity in Disadvantaged Israeli Mothers." British Journal of Social Work 49, no. 4 (April 26, 2019): 899–919. http://dx.doi.org/10.1093/bjsw/bcz048.

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Abstract Guided by the psycho-social environment approach to explaining health inequalities, this cross-sectional study aimed to assess the contribution of individual and community factors to explaining ethnic inequalities in overweight and obesity between Arab and Jewish mothers of young children in Israel. Data (N = 946, 371 Jewish, 575 Arab mothers) were collected by self-report questionnaire in mid-2015 as part of a special ‘Preparation for School’ project for children aged 5–6 years from twenty Mother and Child Health clinics in towns and villages of lowest socio-economic ranking in northern Israel. Multinomial logistic regression models were conducted to assess the effect of socio-economic status (SES), psychological, lifestyle behaviour and community food-related practices on mediating the association of ethnicity with overweight and obesity. Overweight and obesity were significantly higher among Arab mothers. The strength of the association of ethnicity with overweight [(odds ratio) OR = 1.80, 95 per cent confidence interval (CI) = 1.31, 2.47] or obesity (OR = 2.14. 95 per cent CI = 1.44, 3.18) remained constant after SES, and other variables were included in two steps. The persistence of ethnic inequalities suggests that the variables included in the analysis did not explain inequalities in this disadvantaged population. Social work may contribute to understanding additional explanatory variables that have the potential to be amenable to change by multidisciplinary and social work interventions.

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Morgan, Kelly, G. Melendez-Torres, Amy Bond, Jemma Hawkins, Gillian Hewitt, Simon Murphy, and Graham Moore. "Socio-Economic Inequalities in Adolescent Summer Holiday Experiences, and Mental Wellbeing on Return to School: Analysis of the School Health Research Network/Health Behaviour in School-Aged Children Survey in Wales." International Journal of Environmental Research and Public Health 16, no. 7 (March 28, 2019): 1107. http://dx.doi.org/10.3390/ijerph16071107.

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The socioeconomic inequalities found in child and adolescent mental wellbeing are increasingly acknowledged. Although interventions increasingly focus on school holidays as a critical period for intervention to reduce inequalities, no studies have modelled the role of summer holiday experiences in explaining socioeconomic inequalities in wellbeing. For this study, we analysed survey data of 103,971 adolescents from 193 secondary schools in Wales, United Kingdom, which included measures of family affluence, experiences during the summer holidays (hunger, loneliness, time with friends and physical activity) and mental wellbeing and internalising symptoms on return to school. Structural equation modelling was used to analyse the data. Although family affluence retained a direct inverse association with student mental wellbeing (r = −0.04, p < 0.001), 65.2% of its association with mental wellbeing was mediated by the experiences over the summer holidays. FAS score was not directly associated with the student’s self-reports of internalising symptoms (r = 0.00, p > 0.05). Of all summer holiday experiences, the strongest mediational pathway was observed for reports of loneliness. Although more structural solutions to poverty remain essential, school holiday interventions may have significant potential for reducing socioeconomic inequalities in mental health and wellbeing on young people’s return to school through reducing loneliness, providing nutritious food and opportunities for social interaction.

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Nevill, Alan, Paul Donnelly, Simon Shibli, Charlie Foster, and Marie Murphy. "Modifiable Behaviors Help to Explain the Inequalities in Perceived Health Associated With Deprivation and Social Class: Evidence From a National Sample." Journal of Physical Activity and Health 11, no. 2 (February 2014): 339–47. http://dx.doi.org/10.1123/jpah.2012-0044.

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Background:The association between health and deprivation is of serious concern to many health promotion agencies. The purpose of the current study was to assess whether modifiable behaviors of physical activity (PA), sports participation, diet, smoking and body mass index (BMI) can help to explain these inequalities in a sample of 4653 respondents from Northern Ireland.Methods:The study is based on a cross-sectional survey of Northern Irish adults. Responses to a self-rated health question were dichotomized and binary logistic regression was used to identify the health inequalities between areas of high, middle or low deprivation. These differences were further adjusted for other sociodemographic factors and subsequently for various modifiable behaviors of PA, sports participation, diet, smoking, and BMI.Results:Respondents from high and middle areas of deprivation are more likely to report poorer health. As soon as sociodemographic factors and other modifiable behaviors were included, these inequalities either disappeared or were greatly reduced.Conclusion:Many inequalities in health in NI can be explained by the respondents’ sociodemographic characteristics that can be further explained by introducing information about respondents who meet the recommended PA guidelines, play sport, eat 5 portions of fruit and vegetables, and maintain an optimal BMI.

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Boyd, Jennifer, Clare Bambra, Robin C. Purshouse, and John Holmes. "Beyond Behaviour: How Health Inequality Theory Can Enhance Our Understanding of the ‘Alcohol-Harm Paradox’." International Journal of Environmental Research and Public Health 18, no. 11 (June 3, 2021): 6025. http://dx.doi.org/10.3390/ijerph18116025.

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There are large socioeconomic inequalities in alcohol-related harm. The alcohol harm paradox (AHP) is the consistent finding that lower socioeconomic groups consume the same or less as higher socioeconomic groups yet experience greater rates of harm. To date, alcohol researchers have predominantly taken an individualised behavioural approach to understand the AHP. This paper calls for a new approach which draws on theories of health inequality, specifically the social determinants of health, fundamental cause theory, political economy of health and eco-social models. These theories consist of several interwoven causal mechanisms, including genetic inheritance, the role of social networks, the unequal availability of wealth and other resources, the psychosocial experience of lower socioeconomic position, and the accumulation of these experiences over time. To date, research exploring the causes of the AHP has often lacked clear theoretical underpinning. Drawing on these theoretical approaches in alcohol research would not only address this gap but would also result in a structured effort to identify the causes of the AHP. Given the present lack of clear evidence in favour of any specific theory, it is difficult to conclude whether one theory should take primacy in future research efforts. However, drawing on any of these theories would shift how we think about the causes of the paradox, from health behaviour in isolation to the wider context of complex interacting mechanisms between individuals and their environment. Meanwhile, computer simulations have the potential to test the competing theoretical perspectives, both in the abstract and empirically via synthesis of the disparate existing evidence base. Overall, making greater use of existing theoretical frameworks in alcohol epidemiology would offer novel insights into the AHP and generate knowledge of how to intervene to mitigate inequalities in alcohol-related harm.

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Gagné, Thierry, Katherine L. Frohlich, and Thomas Abel. "Cultural capital and smoking in young adults: applying new indicators to explore social inequalities in health behaviour." European Journal of Public Health 25, no. 5 (April 9, 2015): 818–23. http://dx.doi.org/10.1093/eurpub/ckv069.

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Hung, Jason. "Social and Health Inequalities in Rich and Developed Countries: The Role of Sociology and Suggestion of Future Sociological Agendas." JOURNAL OF SOCIAL SCIENCE RESEARCH 12, no. 2 (July 4, 2018): 2691–98. http://dx.doi.org/10.24297/jssr.v12i2.7479.

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In the early 1840s, Friedrich Engels and Rudolph Virchow argued that the â€œmode of social organizationâ€ was a lens through which the social patterning of disease could be understood (Scambler, 2012: 131). Virchow was reluctant to attribute disease to individual behaviour, and asserted that illness belonged to the discipline of social science (de Maio, 2010: 20). In the late 20th century Richard G. Wilkinson, a British social epidemiologist and a professor at University of Nottingham, echoed Engels and Virchow, postulating that Emile Durkheim, if he remained alive, would analyse suicide based on the modern burden in developed societies (Wilkinson, 1996: 15). This article addresses the discourse on how the imbalanced distribution of class, income and social capital contributes to the poorer physical and psychosocial health conditions among socially disadvantaged cohorts, based on the arugments made by key scholars from the field of sociology and health. This article also examines the future sociological agendeas to better examine social and health inequalities, in accordance with ideas suggested by a variety of scholars, especially Graham Scambler. The article is review-based, prompting the understandings of the contemporary debates about social and health inequalities, and what roles should sociology play in such debates.

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Torsheim, Torbjørn, Jens M. Nygren, Mette Rasmussen, Arsæll M. Arnarsson, Pernille Bendtsen, Christina W. Schnohr, Line Nielsen, and Maria Nyholm. "Social inequalities in self-rated health: A comparative cross-national study among 32,560 Nordic adolescents." Scandinavian Journal of Public Health 46, no. 1 (October 17, 2017): 150–56. http://dx.doi.org/10.1177/1403494817734733.

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Aims: We aimed to estimate the magnitude of socioeconomic inequality in self-rated health among Nordic adolescents (aged 11, 13 and 15 years) using the Family Affluence Scale (a composite measure of material assets) and perceived family wealth as indicators of socioeconomic status. Methods: Data were collected from the Health Behaviour in School-aged Children (HBSC) survey in 2013–2014. A sample of 32,560 adolescents from Denmark, Norway, Finland, Iceland, Greenland and Sweden was included in the study. Age-adjusted regression analyses were used to estimate associations between fair or poor self-rated health and the ridit scores for family affluence and perceived wealth. Results: The pooled relative index of inequality of 2.10 indicates that the risk of fair or poor health was about twice as high for young people with the lowest family affluence relative to those with the highest family affluence. The relative index of inequality for observed family affluence was highest in Denmark and lowest in Norway. For perceived family wealth, the pooled relative index of inequality of 3.99 indicates that the risk of fair or poor health was about four times as high for young people with the lowest perceived family wealth relative to those with the highest perceived family wealth. The relative index of inequality for perceived family wealth was highest in Iceland and lowest in Greenland. Conclusions: Social inequality in self-rated health among adolescents was found to be robust across subjective and objective indicators of family affluence in the Nordic welfare states.

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Chakravorty, Triya. "What are the social, psychological and physical health challenges facing adolescents in the UK?" Physician 6, no. 2 (September 15, 2020): 1–6. http://dx.doi.org/10.38192/1.6.2.26.

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The ages of ten to nineteen are monopolised by biological, psychological and sociocultural changes, all of which impact health in the present and future. Behaviours and habits acquired during adolescence can have long-term impacts. Smoking, alcohol use, obesity and physical inactivity are all examples of health-related behaviours that usually start in adolescence and contribute to the global epidemic of non-communicable diseases in adults. These behaviours are influenced by socioeconomic and cultural factors and are major determinants of future health inequalities.

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Thebault, Jean-Laurent, Virginie Ringa, Henri Panjo, Géraldine Bloy, Hector Falcoff, and Laurent Rigal. "Accumulation of unhealthy behaviors: Marked social inequalities in men and women." Preventive Medicine Reports 12 (December 2018): 1–5. http://dx.doi.org/10.1016/j.pmedr.2018.07.008.

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Tiwari, T., L. Jamieson, J. Broughton, H. P. Lawrence, T. S. Batliner, R. Arantes, and J. Albino. "Reducing Indigenous Oral Health Inequalities: A Review from 5 Nations." Journal of Dental Research 97, no. 8 (March 19, 2018): 869–77. http://dx.doi.org/10.1177/0022034518763605.

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Indigenous populations around the world experience a disproportionate burden in terms of oral diseases and conditions. These inequalities are likely due to a complex web of social determinants that includes poverty, historical consequences of colonialism, social exclusion, government policies of assimilation, cultural annihilation, and racism in all its forms (societal, institutional). Despite documented oral health disparities, prevention interventions have been scarce in Indigenous communities. This review describes oral health interventions and their outcomes conducted for Indigenous populations of the United States, Canada, Brazil, Australia, and New Zealand. The review includes research published since 2006 that are available in English in electronic databases, including MEDLINE. A total of 13 studies were included from the United States, Canada, Brazil, and Australia. The studies reviewed provide a wide range of initiatives, including interventions for prevention and treatment of dental disease, as well as interventions that improve oral health knowledge, behaviors, and other psychosocial factors. Overall, 6 studies resulted in improved oral health in the study participants, including improvements in periodontal health, caries reduction, and oral health literacy. Preferred intervention methodologies included community-based research approaches, culturally tailored strategies, and use of community workers to deliver the initiative. Although these studies were conducted with discrete Indigenous populations, investigators reported similar challenges in research implementation. Recommendations for future work in reducing oral health disparities include addressing social determinants of health in various Indigenous populations, training future generations of dental providers in cultural competency, and making Indigenous communities true partners in research.

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Schröder, Sebastian, Johannes Beller, Heiko Golpon, and Siegfried Geyer. "Are there social gradients in the occurrence of lung cancer and in the survival of lung cancer patients? Findings from an observational study using German claims data of Lower Saxony." BMJ Open 10, no. 9 (September 2020): e036506. http://dx.doi.org/10.1136/bmjopen-2019-036506.

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ObjectivesOnly a few studies on health inequalities in terms of lung cancer are available. We examined whether social inequalities are present for the occurrence of lung cancer. Confining the analyses to patients, it was also examined whether survival over the observation period and over a standardised period of 18 months differed by occupational position and income.MethodsOur findings are based on claims data from a German statutory health insurance covering 2005–2016. The database comprised N=3 163 211 women (50.7%) and men (49.3%) aged 18 years and older. Diagnoses (International Statistical Classification of Diseases and Related Health Problems 10th Revision: C34.0 to C34.9) were hospital-based, and income and occupational position were used as indicators of socioeconomic position. Analyses on social gradients were performed for employed and retired insured, but only for employed insured information on occupation and on income were available, for retired women and men only income was available. Analyses were performed by means of proportional hazard regression.ResultsIn employed women, social gradients for the occurrence emerged for occupational position, but not for income. In men, social differences were found for both indicators. For retired insured, income gradients were found in men. Looking at overall survival, neither in women nor in men social gradients emerged.ConclusionsThe reported social inequalities in the occurrence of lung cancer are pointing towards social differences in smoking behaviour, exposition to hazardous occupation-related substances and differences in preventive strategies. The absence of social inequalities in survival after lung cancer suggests equality in medical treatment of the disease.

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Moor, Irene, Mirte A. G. Kuipers, Vincent Lorant, Timo-Kolja Pförtner, Jaana M. Kinnunen, Katharina Rathmann, Julian Perelman, et al. "Inequalities in adolescent self-rated health and smoking in Europe: comparing different indicators of socioeconomic status." Journal of Epidemiology and Community Health 73, no. 10 (July 13, 2019): 963–70. http://dx.doi.org/10.1136/jech-2018-211794.

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BackgroundAlthough there is evidence for socioeconomic inequalities in health and health behaviour in adolescents, different indicators of socioeconomic status (SES) have rarely been compared within one data sample. We examined associations of five SES indicators with self-rated health (SRH) and smoking (ie, a leading cause of health inequalities) in Europe.MethodsData of adolescents aged 14–17 years old were obtained from the 2013 SILNE survey (smoking inequalities: learning from natural experiments), carried out in 50 schools in 6 European cities (N=10 900). Capturing subjective perceptions of relative SES and objective measures of education and wealth, we measured adolescents’ own SES (academic performance, pocket money), parental SES (parental educational level) and family SES (Family Affluence Scale, subjective social status (SSS)). Logistic regression models with SRH and smoking as dependent variables included all SES indicators, age and gender.ResultsCorrelations between SES indicators were weak to moderate. Low academic performance (OR=1.96, 95% CI 1.53 to 2.51) and low SSS (OR=2.75, 95% CI 2.12 to 3.55) were the strongest indicators of poor SRH after adjusting for other SES-indicators. Results for SSS were consistent across countries, while associations with academic performance varied. Low academic performance (OR=5.71, 95% CI 4.63 to 7.06) and more pocket money (OR=0.21, 95% CI 0.18 to 0.26) were most strongly associated with smoking in all countries.ConclusionsSocioeconomic inequalities in adolescent health were largest according to SES indicators more closely related to the adolescent’s education as well as the adolescent’s perception of relative family SES, rather than objective indicators of parental education and material family affluence. For future studies on adolescent health inequalities, consideration of adolescent-related SES indicators was recommended.

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Bourmaud, Aurelie, and Franck Chauvin. "Which communication strategies can improve interventions aimed at tackling social inequalities in organized cancer screening in France?" Global Health Promotion 28, no. 1_suppl (March 2021): 89–92. http://dx.doi.org/10.1177/1757975921989505.

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Interventions to increase participation in cancer screening programs have been developed and evaluated by our research team. The results observed provide an opportunity to consider which methods of communication should be encouraged to improve those interventions. The objective of this commentary is to recommend communication strategies which should be adopted to efficiently reach and support disadvantaged individuals to engage in cancer screening, as a healthy behaviour.

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Samdal, Gro Beate, Eivind Meland, Geir Egil Eide, Sveinung Berntsen, Eirik Abildsnes, Tonje H. Stea, and Thomas Mildestvedt. "Participants at Norwegian Healthy Life Centres: Who are they, why do they attend and how are they motivated? A cross-sectional study." Scandinavian Journal of Public Health 46, no. 7 (March 8, 2018): 774–81. http://dx.doi.org/10.1177/1403494818756081.

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Aims: We examine the characteristics of participants entering Norwegian Healthy Life Centres, their reasons for attending and whether socio-economic status, motivation, self-efficacy and social support relate to physical activity and sedentary behaviour. Methods: This cross-sectional study is part of a randomised controlled trial. Inclusion criteria are that participants should be ≥ 18 years old and able to take part in a physical activity group intervention. Exclusion criteria are severe mental illness and general learning disability. We analysed data using simple and multiple linear regression analyses. Results: We recruited 118 participants from eight Norwegian municipalities between June 2014 and September 2015. Of these, 77% were female, mean (standard deviation) age 48.6 (13.4) years, body mass index 34.0 (5.8) kg/m2 and mean gross family income €61,000. The proportion of participants with upper-secondary school or less as their highest level of education was 55%. The most frequent reasons given for attendance at Healthy Life Centres were being overweight, increasing physical activity, improving diet and having musculoskeletal health challenges. Participants had high levels of autonomous motivation and 79% achieved national recommendations for physical activity. Respect and appreciation in childhood, self-esteem and self-rated health were associated with self-efficacy and social support for physical activity. Conclusions: Participants were predominantly obese, physically active, female and motivated for change. A high proportion had low educational attainment and low incomes. The trial will reveal whether interventions succeed in increasing physical activity further, or in decreasing sedentary behaviour, and whether health inequalities narrow or widen across groups.

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Travis, Cheryl Brown, and Jill D. Compton. "Feminism and Health in the Decade of Behavior." Psychology of Women Quarterly 25, no. 4 (December 2001): 312–23. http://dx.doi.org/10.1111/1471-6402.00031.

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National health data are presented to demonstrate that important issues of women's health are linked to inequality and to the generalized oppression of women. Health issues of violence, reproductive health, coronary health, and mental health are reviewed as they relate to women of color and diverse ethnicity as well as to women in general. Feminist principles are applied to these issues, pointing out inequalities in assessment, treatment and access to care, bias in research and lack of research on topics particularly relevant to women and minorities, and limitations in the education and training of health care providers. It is imperative that these problems, which are not solely biological, be addressed in light of systems-level analysis that includes a feminist lens. Guided by feminist principles and sensibilities, the relevance of behavioral and social science is outlined for research, training, assessment, intervention, evaluation, and overall social change.

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Journal articles on the topic 'Social inequalities in health and health behaviour'

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