Using the Shapley Decomposition to Disentangle the Impact of Circumstances and Efforts on Health Inequality

2017 ◽  
Vol 138 (2) ◽  
pp. 523-543 ◽  
Author(s):  
Joseph Deutsch ◽  
María Noel Pi Alperin ◽  
Jacques Silber
Keyword(s):  
Health Inequality ◽  
Shapley Decomposition ◽  
The Impact

Education level, underemployment, and workers’ health

2021 ◽  
Author(s):  
Nan Li ◽  
Dan Wu
Keyword(s):  
Health Inequality ◽  
Economic Effect ◽  
Empirical Support ◽  
Education Level ◽  
Educational Levels ◽  
Protection Mechanism ◽  
Low Education ◽  
The Difference ◽  
The Impact ◽  
Level Group

Under the dual background of underemployment and health inequality, this paper empirically analyzes the impact of education level on underemployed workers’ health based on CLDS2016 data. The results show that underemployment is significantly related to the decline of self-rated health, increased depression tendency, and morbidity in a certain period. The results indicate that underemployment can significantly reduce the health level of workers in the low education level group and the high education level group. However, it has no significant impact on workers’ health in the middle education level group; even if we change the measurement method of indicators and consider endogeneity, the research conclusion is still robust. Moreover, this kind of health inequality mainly comes from the difference in economic effect and leisure effect of underemployment to workers with different educational levels. This paper provides empirical support for increasing the labor protection mechanism of underemployed people and reducing the health inequality caused by educational level differences.

scholarly journals Impact of Socioeconomic Differences on Distributional Cost-effectiveness Analysis

2020 ◽  
Vol 40 (5) ◽  
pp. 606-618
Author(s):  
Fan Yang ◽  
Colin Angus ◽  
Ana Duarte ◽  
Duncan Gillespie ◽  
Simon Walker ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Inequality ◽  
Local Level ◽  
National Level ◽  
Cost Effectiveness Analysis ◽  
Decision Makers ◽  
Socioeconomic Differences ◽  
Screening And Brief Intervention ◽  
Effectiveness Analysis ◽  
The Impact

Public health decision makers value interventions for their effects on overall health and health inequality. Distributional cost-effectiveness analysis (DCEA) incorporates health inequality concerns into economic evaluation by accounting for how parameters, such as effectiveness, differ across population groups. A good understanding of how and when accounting for socioeconomic differences between groups affects the assessment of intervention impacts on overall health and health inequality could inform decision makers where DCEA would add most value. We interrogated 2 DCEA models of smoking and alcohol policies using first national level and then local authority level information on various socioeconomic differences in health and intervention use. Through a series of scenario analyses, we explored the impact of altering these differences on the DCEA results. When all available evidence on socioeconomic differences was incorporated, provision of a smoking cessation service was estimated to increase overall health and increase health inequality, while the screening and brief intervention for alcohol misuse was estimated to increase overall health and reduce inequality. Ignoring all or some socioeconomic differences resulted in minimal change to the estimated impact on overall health in both models; however, there were larger effects on the estimated impact on health inequality. Across the models, there were no clear patterns in how the extent and direction of socioeconomic differences in the inputs translated into the estimated impact on health inequality. Modifying use or coverage of either intervention so that each population group matched the highest level improved the impacts to a greater degree than modifying intervention effectiveness. When local level socioeconomic differences were considered, the magnitude of the impacts was altered; in some cases, the direction of impact on inequality was also altered.

scholarly journals Better Choice, Better Health? Social Integration and Health Inequality among International Migrants in Hangzhou, China

2020 ◽  
Vol 17 (13) ◽  
pp. 4787
Author(s):  
Xiaoguang Fan ◽  
Fei Yan ◽  
Wei Yan
Keyword(s):  
Socioeconomic Status ◽  
Social Integration ◽  
Health Inequality ◽  
Developed Countries ◽  
The Self ◽  
Factors Affecting ◽  
Self Rated Health ◽  
Starting Point ◽  
International Migrants ◽  
The Impact

The aim of this study is to investigate the impact of social integration and socioeconomic status on immigrant health in China. Taking the framework of social determinants of health (SDH) as the theoretical starting point, this paper uses the Hangzhou sample of the 2018 Survey of Foreigners in China (SFRC2018) to explore two core factors affecting the health inequality of international migrants in China: the level of social integration following settlement, and socioeconomic status before and after coming to China. The results show that having a formal educational experience in China helped improve both the self-rated health status and self-assessed change in health of international migrants; that the socioeconomic status of an emigrant’s home country affected self-rated health; and that the self-assessed change in health of immigrants from developing countries was significantly higher than those from developed countries. This study concludes that the health inequalities of immigrant populations in China must be understood in the context of China’s specific healthcare system and treatment structure.

Respiratory health inequality starts early: The impact of social determinants on the aetiology and severity of bronchiolitis in infancy

2018 ◽  
Vol 55 (5) ◽  
pp. 528-532 ◽  
Author(s):  
David Foley ◽  
Elspeth Best ◽  
Nicholas Reid ◽  
Max (Mary) J Berry
Keyword(s):  
Health Inequality ◽  
Social Determinants ◽  
Respiratory Health ◽  
The Impact

scholarly journals Wealth, Health, and Disability Gaps at Midlife: Implications for Disparate Retirement Outcome

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 586-586
Author(s):  
Stephen Crystal
Keyword(s):  
Health Inequality ◽  
Generation X ◽  
Late Life ◽  
Wealth Accumulation ◽  
Survey Of Consumer Finances ◽  
Policy Choices ◽  
Consumer Finances ◽  
Increasing Risk ◽  
Deaths Of Despair ◽  
The Impact

Abstract Late-life economic outcomes in coming years will be strongly shaped by the impact of economic and health experience for cohorts now at midlife. These cohorts have experienced lagging and increasingly disparate wealth accumulation, along with challenges to health and earning potential that augur highly disparate retirement futures. For example, analyses of Survey of Consumer Finances data indicate that in 2016, members of Generation X had mean assets that were only 39% those of the boomers in that year. Increasing risk of “deaths of despair” among individuals in midlife have been accompanied by increases in disability that threaten the ability of those members of these cohorts who are not in the educationally advantaged minority to achieve secure retirement futures, particularly in the context of increasing employment precarity. This presentation will review recent findings on midlife wealth and health inequality, implications for retirement futures, and policy choices facing a new Presidential administration.

scholarly journals Health inequality in the tropics and its costs: a Sustainable Development Goals alert

2020 ◽  
Vol 12 (5) ◽  
pp. 395-410
Author(s):  
Emily J Callander ◽  
Stephanie M Topp
Keyword(s):  
Health Inequality ◽  
Communicable Disease ◽  
Economic Cost ◽  
Middle Income ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Disease Study ◽  
The Tropics ◽  
Lower Income Countries ◽  
The Impact

Abstract Background It is known that health impacts economic performance. This article aims to assess the current state of health inequality in the tropics, defined as the countries located between the Tropic of Cancer and the Tropic of Capricorn, and estimate the impact of this inequality on gross domestic product (GDP). Methods We constructed a series of concentration indices showing between-country inequalities in disability-adjusted life years (DALYs), taken from the Global Burden of Disease Study. We then utilized a non-linear least squares model to estimate the influence of health on GDP and counterfactual analysis to assess the GDP for each country had there been no between-country inequality. Results The poorest 25% of the tropical population had 68% of the all-cause DALYs burden in 2015; 82% of the communicable, maternal, neonatal and nutritional DALYs burden; 55% of the non-communicable disease DALYs burden and 61% of the injury DALYs burden. An increase in the all-cause DALYs rate of 1/1000 resulted in a 0.05% decrease in GDP. If there were no inequality between countries in all-cause DALY rates, most high-income countries would see a modest increase in GDP, with low- and middle-income countries estimated to see larger increases. Conclusions There are large and growing inequalities in health in the tropics and this has significant economic cost for lower-income countries.

scholarly journals Impact of guidance publication on primary care prescribing rates of simple analgesia: an interrupted time series analysis in England

2020 ◽  
pp. bjgp20X714101
Author(s):  
Hannah Reichel ◽  
Rhian Stanbrook ◽  
Hans Johnson ◽  
William Proto ◽  
Mary Shantikumar ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Time Series Analysis ◽  
Health Inequality ◽  
Implementation Intentions ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Practice Level ◽  
Series Analysis ◽  
The Impact

Abstract Background: In March 2018, NHS England published guidance for Clinical Commissioning Groups (CCGs; NHS bodies that commission health services for local areas) to encourage implementation of policy to reduce primary care prescriptions of over-the-counter medications, including simple analgesia. Aims: To investigate: the impact of guidance publication on prescribing rates of simple analgesia (oral paracetamol, oral ibuprofen and topical non-steroidal anti-inflammatory drugs [NSAIDS]) in primary care; CCG implementation intentions; and whether it has created a health inequality based on socioeconomic status. Design and Setting: Interrupted time series analysis of primary care prescribing data in England. Methods: Practice-level prescribing data from January 2015 to March 2019 were obtained from NHS Digital. Interrupted time series analyses assessed the association of guidance publication with prescribing rates. The association between practice-level prescribing rates and Index of Multiple Deprivation score (a marker of socioeconomic deprivation) before and after publication was quantified using multivariable Poisson regression. Freedom of information requests were submitted to all CCGs. Results: There was a 4% reduction in prescribing of simple analgesia following guidance publication (adjusted incidence rate ratio [aIRR] 0.96, 95% CI 0.92-0.99, p=0.027), adjusting for underlying time trend and seasonality. Practice-level prescribing rates were greater in more deprived areas. There was considerable diversity across CCGs in whether or how they chose to implement the guidance. Conclusion: Guidance publication was associated with a small reduction in the prescribing rates of simple analgesia across England, without evidence of creating an additional health inequality.

Introduction to the “Evaluating the Impact of Structural Policies on Health Inequalities and Their Social Determinants and Fostering Change” (SOPHIE) Project

2016 ◽  
Vol 47 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Carme Borrell ◽  
Davide Malmusi ◽  
Carles Muntaner
Keyword(s):  
Labor Market ◽  
Health Inequalities ◽  
Working Conditions ◽  
Health Inequality ◽  
Social Determinants ◽  
Social Stratification ◽  
Structural Determinants ◽  
Health Related ◽  
The Impact ◽  
Specific Health

The SOPHIE Project (acronym for Structural Policies for Health Inequalities Evaluation) has focused on evaluating the impact of structural policies on health equity, considering as such all those policies that exert a powerful influence on the structural determinants of health (e.g., patterns of social stratification, living and working conditions) and thus on health-related exposures through intermediary determinants. In these sections of the International Journal of Health Services, we present some of the main findings of the SOPHIE Project. We include both articles that summarize all the evidence already published in the project on a thematic area (such as labor market, gender, or housing) and articles that present new, unpublished evidence on a specific health inequality or policy.

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