scholarly journals Mapping socioeconomic inequalities in malaria in Sub-Sahara African countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gabriel Carrasco-Escobar ◽  
Kimberly Fornace ◽  
Tarik Benmarhnia
Keyword(s):  
Malaria Prevalence ◽  
Socioeconomic Inequalities ◽  
Eastern Africa ◽  
Economic Wealth ◽  
Relative Index ◽  
Incidence And Mortality ◽  
Wide Range ◽  
Index Of Inequality ◽  
Relative Index Of Inequality ◽  
Ssa Countries

AbstractDespite reductions in malaria incidence and mortality across Sub-Saharan (SSA) countries, malaria control and elimination efforts are currently facing multiple global challenges such as climate and land use change, invasive vectors, and disruptions in healthcare delivery. Although relationships between malaria risks and socioeconomic factors have been widely demonstrated, the strengths and variability of these associations have not been quantified across SSA. In this study, we used data from population-based malaria indicator surveys in SSA countries to assess spatial trends in relative and absolute socioeconomic inequalities, analyzed as social (mothers’ highest educational level—MHEL) and economic (wealth index—WI) inequalities in malaria prevalence. To capture spatial variations in socioeconomic (represented by both WI and MHEL) inequalities in malaria, we calculated both the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) in each administrative region. We also conducted cluster analyses based on Local Indicator of Spatial Association (LISA) to consider the spatial auto-correlation in SII and RII across regions and countries. A total of 47,404 participants in 1874 Primary Sampling Units (PSU) were analyzed across the 13 SSA countries. Our multi-country assessment provides estimations of strong socioeconomic inequalities between and within SSA countries. Such within- and between- countries inequalities varied greatly according to the socioeconomic metric and the scale used. Countries located in Eastern Africa showed a higher median Slope Index of Inequality (SII) and Relative Index of Inequality (RII) in malaria prevalence relative to WI in comparison to countries in other locations across SSA. Pockets of high SII in malaria prevalence in relation to WI and MHEL were observed in the East part of Africa. This study was able to map this wide range of malaria inequality metrics at a very local scale and highlighted the spatial clustering patterns of pockets of high and low malaria inequality values.

scholarly journals Diabetes: Socioeconomic Inequalities in the Portuguese Population in 2014

2017 ◽  
Vol 30 (7-8) ◽  
pp. 561 ◽  
Author(s):  
Joana Santos ◽  
Irina Kislaya ◽  
Liliana Antunes ◽  
Ana João Santos ◽  
Ana Paula Rodrigues ◽  
...  
Keyword(s):  
Educational Level ◽  
Concentration Index ◽  
Public Health Problem ◽  
Universal Coverage ◽  
Socioeconomic Inequalities ◽  
Major Public Health Problem ◽  
Relative Index ◽  
The People ◽  
Access To Health ◽  
Index Of Inequality

Introduction: Diabetes is a major public health problem and it is related to socioeconomic factors. The aim of this study is to describe socioeconomic inequalities in the distribution of diabetes in the population with 25 years or more, resident in Portugal in 2014.Material and Methods: Data from the Health National Survey 2014 was analysed, n = 16 786. We estimated the prevalence of diabetes in the population and stratified by socioeconomic variables namely educational level and income. The extent of socioeconomic inequalities was assessed using concentration index and the relative index of inequality.Results: Diabetes was found to be concentrated among the people with lower educational levels (concentration index = -0.26) and lower income quintiles (concentration index = -0.14). Relative index of inequality also showed a lower degree of inequality among the most educated (0,20; CI 95% = [0,12; 0,32]) and with higher income (0,59; CI 95% = [0,48; 0,74]).Discussion: Distribution of diabetes is associated with education and income. Previous studies have shown that although income might reflect lifestyle patterns, education reflects better social factors that are important for establishing healthier behaviours. Also, the National Health Service, of universal coverage and free of charge, might have contributed to reduce inequalities in the access to health by those with the lowest income.Conclusion: Supporting ‘Health in All Policies’ might reduce inequalities, namely by improving population educational level and actions that promote health literacy.

scholarly journals Trends in socioeconomic inequalities in the prevalence of functional dentition among older people in Brazil

2018 ◽  
Vol 34 (10) ◽  
Author(s):  
Fabiola Bof de Andrade ◽  
Jose Leopoldo Ferreira Antunes
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Socioeconomic Inequalities ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Relative Index ◽  
Functional Dentition ◽  
Natural Teeth ◽  
Index Of Inequality ◽  
Position Measure

The objective of this research was to evaluate trends in socioeconomic inequalities in the prevalence of functional dentition among community-dwelling older adults in Brazil. This was a cross-sectional study with data from the last two SBBrasil Project surveys conducted in 2003 and 2010. Functional dentition was defined as the presence of 20 or more natural teeth and was assessed during the clinical examination of dentition status. Schooling was used as the socioeconomic position measure. Socioeconomic inequality was measured using two complex measures; the slope index of inequality (SII) and the relative index of inequality (RII). The prevalence of functional dentition was 10.8% (95%CI: 8.1-14.2) in 2003 and 13.6% (95%CI: 11.1-16.5) in 2010. The prevalence of functional dentition increased significantly over the educational rank in both years. Absolute inequalities were significant for both years and remained unaltered between 2003 and 2010. Significant relative inequality in the prevalence of functional dentition was found in both years of the survey. Socioeconomic inequalities in the prevalence of functional dentition among older adults in Brazil persisted significantly between both national oral health surveys.

Social inequalities in self-rated health: A comparative cross-national study among 32,560 Nordic adolescents

2017 ◽  
Vol 46 (1) ◽  
pp. 150-156 ◽  
Author(s):  
Torbjørn Torsheim ◽  
Jens M. Nygren ◽  
Mette Rasmussen ◽  
Arsæll M. Arnarsson ◽  
Pernille Bendtsen ◽  
...  
Keyword(s):  
Young People ◽  
Social Inequalities ◽  
Poor Health ◽  
National Study ◽  
Family Affluence ◽  
Relative Index ◽  
Self Rated Health ◽  
Family Wealth ◽  
Index Of Inequality ◽  
Relative Index Of Inequality

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.

scholarly journals An Islamic Perspective on Inequality in Pakistan

1992 ◽  
Vol 31 (3) ◽  
pp. 295-316
Author(s):  
Geoffrey A. Jehle
Keyword(s):  
Significant Decline ◽  
Data Series ◽  
Relative Index ◽  
Islamic Perspective ◽  
Urban Rural ◽  
Index Of Inequality ◽  
Relative Index Of Inequality ◽  
Distribution Of Income ◽  
Very High

This paper examines the distribution of income in Pakistan, and in each of its four provinces, from an explicit and formal Islamic perspective. A cardinally significant Atkinson-Kolm-Sen relative index of inequality reflecting that perspective is proposed and computed from the full HIES data series for the years 1984-85, 1985-86, 1986-87, and 1987-88. There is evidence of a significant decline in overall inequality in Pakistan from 1984-85 to 1987-88, but the level of inequality remains very high. Inter-province and inter-urban/rural differences in inequality profiles within Pakistan and each of its provinces are found to be generally less. significant than intra-province and intraurban/ rural differences.

scholarly journals Trends in Socioeconomic Inequalities in Hypertension in Ontario, Canada, 2000-2012

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Simran Shokar ◽  
Laura Rosella ◽  
Peter Smith ◽  
Hong Chen ◽  
Heather ChenManson ◽  
...  
Keyword(s):  
Risk Factor ◽  
Household Income ◽  
Socioeconomic Inequalities ◽  
Material Deprivation ◽  
Discharge Abstract Database ◽  
Ontario Health Insurance Plan ◽  
Cross Sectional ◽  
Study Objective ◽  
Relative Index ◽  
Index Of Inequality

IntroductionHypertension is leading risk factor for cardiovascular disease and mortality. Low socioeconomic position (e.g., income or high material deprivation) is an important risk factor for hypertension. However, there is limited evidence monitoring the extent to which socioeconomic inequalities in hypertension exist and are changing over time in Ontario. Objectives and ApproachThe study objective was to estimate socioeconomic trends in prevalent hypertension by household income and material deprivation in Ontario from 2000 to 2012. A pooled cross-sectional study was conducted using data from 6 Canadian Community Health Surveys linked to the Discharge Abstract Database and Ontario Health Insurance Plan data (n=121,390 over 35 years, 54\% female). Relative-weighted Poisson regression models were used to estimate hypertension rates (adjusted for age, sex, ethnicity and immigration) across quintiles of equivalized household income and area-level material deprivation. Socioeconomic inequalities were estimated using the slope index of inequality (SII) and relative index of inequality (RII). ResultsSocioeconomic inequalities in hypertension were observed across income quintiles on both absolute (SII: 1428 per 10,000, 95\%CI:1126,1730) and relative (RII:1.74, 95\%CI:1.53,1.94) scales in 2000, decreasing by 2012 (SII:297 per 10,000, 95%CI: -82,676; RII:1.19, 95%CI:0.93,1.45). A similar pattern was observed across material deprivation quintiles, however with smaller inequalities in 2000 (SII:595 per 10,000, 95%CI:306,884; RII:1.25, 95%CI:1.11,1.39) and 2012 (SII:389 per 10,000, 95%CI:17,761; RII:1.24, 95%CI:0.99,1.49). Conclusion/ImplicationsSocioeconomic inequalities in hypertension were observed in Ontario, with decreasing trends between 2000 and 2012. Area-level material deprivation underestimated individual-level socioeconomic inequalities in hypertension.

scholarly journals Trends in socioeconomic inequalities in childhood BCG immunization coverage in Pakistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Zaheer ◽  
S Kanwal ◽  
K Shafique
Keyword(s):  
Vaccination Coverage ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Socioeconomic Inequalities ◽  
Reproductive Age ◽  
Demographic And Health Surveys ◽  
High Burden ◽  
Relative Index ◽  
Bcg Vaccination ◽  
Index Of Inequality

Abstract Background Although, WHO notes that there has been 'tremendous progress' towards controlling spread of Tuberculosis (TB) by 2015, situation in endemic countries like Pakistan need global attention. Pakistan currently ranks fifth among TB-high burden countries and it accounts for 61% of the TB burden in the WHO Eastern Mediterranean Region. We aim to explore the trends in relative and absolute socioeconomic inequalities in BCG vaccination coverage. Methods Data from Pakistan Demographic and Health Surveys (PDHS) 2006-7 (n = 9177 data used 8442), and 20012-13 (n = 13558, used n = 6982) were used. Information was collected from all mothers in reproductive age group, regarding BCG vaccination of their children aged < 5 years. Wealth index and education were used to assess socioeconomic position. Socioeconomic inequalities for BCG vaccination coverage were assessed by calculating Relative Index of Inequality (RII) and Absolute Index of Inequality (SII). Results Although reported frequency of not getting the child BCG vaccinated has decreased over the decade (25% in 2006, 18% in 2013). Nevertheless, socioeconomic inequalities in BCG vaccination have significantly widened over the last decade. Education related inequalities [2006-7 Urban: SII=-1.34 (-0.91, -1.76); 2012-13 Urban: SII=-1.88 (-1.43, -2.32)]; [2006-7 Rural: SII=-1.31 (-0.96, -1.65); 2012-13 Rural: SII=-1.54 (-1.13, -1.94)] have increased. Similarly, wealth related inequalities [2006-7 Urban: SII=-1.27 (-0.91, -1.62); 2012-13 Urban: SII=-1.75 (-1.37, -2.12)]; [2006-7 Rural: SII=-1.19 (-0.98, -1.39); 2012-13 Rural: SII=-1.72 (-1.43, -2.00)] have increased. Conclusions Widening absolute inequalities in BCG vaccination coverage among children over the last decade in a TB-high burden country gives rise to global concern, at a time when world aims for tuberculosis free future. The results warrant the essential public health efforts to avoid further widening in TB related socioeconomic inequalities in Pakistan. Key messages The results warrant the need to continue monitoring of TB control at population level. Study findings may help to improved TB management programs to initiate evidence-based guidelines for maternal and child health.

scholarly journals Trends in socioeconomic inequalities in smoking in Turkey from 2008 to 2016

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hur Hassoy ◽  
Isil Ergin ◽  
Gorkem Yararbas
Keyword(s):  
Older Women ◽  
Epidemic Model ◽  
Early Stage ◽  
Age Groups ◽  
Socioeconomic Inequalities ◽  
Cross Sectional ◽  
Relative Index ◽  
Younger Women ◽  
Index Of Inequality ◽  
Wealth Inequalities

Abstract Background Smoking inequalities in Turkey were previously demonstrated in an early stage of the smoking epidemic model. This paper aimed to assess the trends for socioeconomic inequalities in smoking in Turkey over the years in the context of the smoking epidemic model using data from the Global Adult Tobacco Survey (GATS) Turkey 2008–2012-2016. Methods Cross-sectional data were analyzed to calculate the association of smoking with, wealth, education, occupation and place of residence using age-standardized prevalence rates, odds ratios, relative index of inequality (RII) and slope index of inequality (SII). The analysis was performed separately for age groups (younger: 20–39 years/older: 40 and above years) and sex. Results Younger women with higher wealth and older women with higher wealth and education smoked more. For both age groups, smoking was increased for working class and urban women. Relative wealth inequalities in smoking narrowed and then showed a reversal for younger women (RII2008 = 3.37; 95% CI:1.64–3.40; RII2012 = 2.19; 95% CI:1.48–3.24; RII2016 = 0.80; 95% CI:0.58–1.10, p-for trend < 0.0001). Relative educational inequalities in smoking for older women also showed a narrowing (RII2008 = 21.45; 95% CI:11.74–39.19; RII2012 = 15.25; 95% CI:9.10–25.55; and RII2016 = 5.48; 95% CI:3.86–7.78, p-for trend < 0.0001). For older women, a similar narrowing was observed for wealth (RII2008 = 3.94; 95% CI:2.38–6.53; RII2012 = 2.79; 95% CI:1.80–4.32; and RII2016 = 1.34; 95% CI:0.94–1.91, p-for trend = 0.0001). The only significant trend for absolute inequalities was for younger women by wealth. This trend showed a narrowing and then a reversal (SII2008 = 0.14; 95% CI:0.09–1.20; SII2012 = 0.12; 95% CI:0.06–0.18; and SII2016 = -0.05; 95% CI:-0.12–0.02, p-for trend = 0.0001). Unlike women, smoking in men showed inverse associations for wealth and education, although not statistically confirmed for all years. Smoking was increased in working classes and unemployed men in 2012 and 2016. Inequalities did not show a trend in relative and absolute terms for men. Conclusions For smoking inequalities in Turkey, a transition to the next stage was observed, although the previously defined Southern European pattern also existed. Low socioeconomic women deserve special attention as well as stressors at work and drivers of smoking at urban settings.

scholarly journals Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

2019 ◽  
Author(s):  
Raquel Ferreira ◽  
Maria Inês Barreiros Senna ◽  
Lorrany Gabriele Rodrigues ◽  
Fernanda Lamounier Campos ◽  
Andrea Maria Eleuterio de Barros Lima Martins ◽  
...  
Keyword(s):  
Tooth Loss ◽  
Education Level ◽  
Socioeconomic Inequalities ◽  
Socioeconomic Indicators ◽  
Relative Index ◽  
Individual Level ◽  
Contextual Variation ◽  
Index Of Inequality ◽  
The Individual ◽  
Municipal Level

Abstract Background: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. Methods: Data from the 2010 National Oral Health Survey of 9,979 adults living in 177 Brazilian municipalities were used. Education and household income were used as the individual socioeconomic indicators. At the municipal level, we used the Municipal Human Development Index as our contextual indicator of socioeconomic status (low:<0.699 versus high: >0.70). The Relative Index of Inequality (RII) and the Slope Index of Inequality (SII) were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. Results: At the individual level, adults with lower education & income reported more tooth loss. The mean number of lost teeth was 9.62 (95%CI: 8.02-11.23) and 7.03 (95%CI: 6.52-7.55) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer lost teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI. Conclusions: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

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