scholarly journals Monitoring inequalities in self-rated health over 36 years among Finnish women and men

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Lahelma ◽  
O Pietiläinen ◽  
O Pentala-Nikulainen ◽  
S Helakorpi ◽  
O Rahkonen
Keyword(s):  
Health Inequalities ◽  
Global Financial Crisis ◽  
Economic Recession ◽  
Continuous Variable ◽  
Educational Inequalities ◽  
Men And Women ◽  
Relative Index ◽  
Women Health ◽  
Self Rated Health ◽  
Index Of Inequality

Abstract Background Health inequalities across countries and populations are well established, but little is known about their long-term trends and even less about factors shaping the trends. We examined the magnitude of absolute and relative educational inequalities in self-rated health over 36 years among adult Finns, considering individual covariates and macro-economic fluctuations. Methods Data were derived from representative annual surveys in 1979-2014 among men and women and covered ages 25-64. Nine periods were used (n = 8870-14235). Our health outcome was less-than-good self-rated health and our socioeconomic indicator was completed years of education as a continuous variable. Nine time-variant sociodemographic and health-related covariates were included. Educational inequalities in self-rated health were examined by relative index of inequality (RII) and slope index of inequality (SII). Results Linear trends suggested stable overall development in both relative and absolute health equalities during 36 years. Period specific analyses showed that among men relative and absolute inequalities narrowed immediately after economic recession in Finland in 1993-94, and among women, inequalities narrowed during global financial crisis in 2008-09. Adjusting for covariates reduced the magnitude of inequalities throughout the nine periods, but affected little the period specific patterning of health inequalities. Conclusions Educational inequalities in self-rated health persisted during 36 years in Finland. While among men and women health inequalities narrowed during and after recessions, they widened soon back to the pre-recession level. The perseverance calls for powerful measures to tackle health inequalities, such as preventing unhealthy behaviours, obesity and unemployment in particular among the lower educated. Key messages Health inequalities have persisted in Finland over 36 years, with unhealthy behaviors and unemployment affecting their magnitude. Health inequalities narrowed during economic recessions, but widened soon back to pre-recession level.

scholarly journals Educational Inequalities in Self-Rated Health in Europe and South Korea

2020 ◽  
Vol 17 (12) ◽  
pp. 4504
Author(s):  
Minhye Kim ◽  
Young-Ho Khang ◽  
Hee-Yeon Kang ◽  
Hwa-Kyung Lim
Keyword(s):  
Health Inequalities ◽  
Outcome Variable ◽  
The European Union ◽  
Relative Index ◽  
Highly Educated ◽  
Adult Men ◽  
Self Rated Health ◽  
Health And Nutrition ◽  
Index Of Inequality ◽  
High Level

While numerous comparative works on the magnitude of health inequalities in Europe have been conducted, there is a paucity of research that encompasses non-European nations such as Asian countries. This study was conducted to compare Europe and Korea in terms of educational health inequalities, with poor self-rated health (SRH) as the outcome variable. The European Union Statistics on Income and Living Conditions and the Korea National Health and Nutrition Examination Survey in 2017 were used (31 countries). Adult men and women aged 20+ years were included (207,245 men and 238,007 women). The age-standardized, sex-specific prevalence of poor SRH by educational level was computed. The slope index of inequality (SII) and relative index of inequality (RII) were calculated. The prevalence of poor SRH was higher in Korea than in other countries for both low/middle- and highly educated individuals. Among highly educated Koreans, the proportion of less healthy women was higher than that of less healthy men. Korea’s SII was the highest for men (15.7%) and the ninth-highest for women (10.4%). In contrast, Korea’s RII was the third-lowest for men (3.27), and the lowest among women (1.98). This high-SII–low-RII mix seems to have been generated by the high level of baseline poor SRH.

Educational and wealth inequalities in tobacco use among men and women in 54 low-income and middle-income countries

2016 ◽  
Vol 27 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Chandrashekhar T Sreeramareddy ◽  
Sam Harper ◽  
Linda Ernstsen
Keyword(s):  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Low Income ◽  
Socioeconomic Inequalities ◽  
Educational Inequalities ◽  
Middle Income ◽  
Men And Women ◽  
Middle Income Countries ◽  
Index Of Inequality ◽  
Wealth Inequalities

BackgroundSocioeconomic differentials of tobacco smoking in high-income countries are well described. However, studies to support health policies and place monitoring systems to tackle socioeconomic inequalities in smoking and smokeless tobacco use common in low-and-middle-income countries (LMICs) are seldom reported. We aimed to describe, sex-wise, educational and wealth-related inequalities in tobacco use in LMICs.MethodsWe analysed Demographic and Health Survey data on tobacco use collected from large nationally representative samples of men and women in 54 LMICs. We estimated the weighted prevalence of any current tobacco use (including smokeless tobacco) in each country for 4 educational groups and 4 wealth groups. We calculated absolute and relative measures of inequality, that is, the slope index of inequality (SII) and relative index of inequality (RII), which take into account the distribution of prevalence across all education and wealth groups and account for population size. We also calculated the aggregate SII and RII for low-income (LIC), lower-middle-income (lMIC) and upper-middle-income (uMIC) countries as per World Bank classification.FindingsMale tobacco use was highest in Bangladesh (70.3%) and lowest in Sao Tome (7.4%), whereas female tobacco use was highest in Madagascar (21%) and lowest in Tajikistan (0.22%). Among men, educational inequalities varied widely between countries, but aggregate RII and SII showed an inverse trend by country wealth groups. RII was 3.61 (95% CI 2.83 to 4.61) in LICs, 1.99 (95% CI 1.66 to 2.38) in lMIC and 1.82 (95% CI 1.24 to 2.67) in uMIC. Wealth inequalities among men varied less between countries, but RII and SII showed an inverse pattern where RII was 2.43 (95% CI 2.05 to 2.88) in LICs, 1.84 (95% CI 1.54 to 2.21) in lMICs and 1.67 (95% CI 1.15 to 2.42) in uMICs. For educational inequalities among women, the RII varied much more than SII varied between the countries, and the aggregate RII was 14.49 (95% CI 8.87 to 23.68) in LICs, 3.05 (95% CI 1.44 to 6.47) in lMIC and 1.58 (95% CI 0.33 to 7.56) in uMIC. Wealth inequalities among women showed a pattern similar to that of men: the RII was 5.88 (95% CI 3.91 to 8.85) in LICs, 1.76 (95% CI 0.80 to 3.85) in lMIC and 0.39 (95% CI 0.09 to 1.64) in uMIC. In contrast to men, among women, the SII was pro-rich (higher smoking among the more advantaged) in 13 of the 52 countries (7 of 23 lMIC and 5 of 7 uMIC).InterpretationOur results confirm that socioeconomic inequalities tobacco use exist in LMIC, varied widely between the countries and were much wider in the lowest income countries. These findings are important for better understanding and tackling of socioeconomic inequalities in health in LMIC.

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 Widespread and widely widening? Examining absolute socioeconomic health inequalities in northern Sweden across twelve health indicators

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Kinza Degerlund Maldi ◽  
Miguel San Sebastian ◽  
Per E. Gustafsson ◽  
Frida Jonsson
Keyword(s):  
Health Inequalities ◽  
Physical Inactivity ◽  
Dental Health ◽  
Health Indicators ◽  
Socioeconomic Inequalities ◽  
Educational Inequalities ◽  
Self Rated Health ◽  
Income Inequalities ◽  
Socioeconomic Health Inequalities

Abstract Background Socioeconomic inequalities in health is a widely studied topic. However, epidemiological research tends to focus on one or a few outcomes conditioned on one indicator, overlooking the fact that health inequalities can vary depending on the outcome studied and the indicator used. To bridge this gap, this study aims to provide a comprehensive picture of the patterns of socioeconomic health inequalities in Northern Sweden over time, across a range of health outcomes, using an ‘outcome-wide’ epidemiological approach. Method Cross-sectional data from three waves of the ‘Health on Equal Terms’ survey, distributed in 2006, 2010 and 2014 were used. Firstly, socioeconomic inequalities by income and education for twelve outcomes (self-rated health, self-rated dental health, overweight, hypertension, diabetes, long-term illness, stress, depression, psychological distress, smoking, risky alcohol consumption, and physical inactivity) were examined by calculating the Slope Index of Inequality. Secondly, time trends for each outcome and socioeconomic indicator were estimated. Results Income inequalities increased for psychological distress and physical inactivity in men as well as for self-rated health, overweight, hypertension, long-term illness, and smoking among women. Educational inequalities increased for hypertension, long-term illness, and stress (the latter favouring lower education) in women. The only instance of decreasing income inequalities was seen for long-term illness in men, while education inequalities decreased for long-term illness in men and poor self-rated health, poor self-rated dental health, and smoking in women. Conclusion Patterns of absolute socioeconomic inequalities in health vary by health and socioeconomic indicator, as well as between men and women. Overall, trends appear more stagnant in men while they fluctuate in women. Income inequalities seem to be generally greater than educational inequalities when looking across several different health indicators, a message that can only be derived from this type of outcome-wide study. These disparate findings suggest that generalised and universal statements about the development of health inequalities can be too simplistic and potentially misleading. Nonetheless, despite inequalities being complex, they do exist and tend to increase. Thus, an outcome-wide approach is a valuable method which should be utilised to generate evidence for prioritisations of policy decisions.

scholarly journals Educational Inequalities in Self-Rated Health across US States and European Countries

2017 ◽  
Author(s):  
Patrick Präg ◽  
SV Subramanian
Keyword(s):  
Health Inequalities ◽  
Binary Logistic Regression ◽  
European Countries ◽  
Behavioral Risk ◽  
Educational Inequalities ◽  
Us States ◽  
Federal States ◽  
Self Rated Health ◽  
The Us ◽  
Vast Variation

The US show a distinct health disadvantage when compared to other high-income nations. A potential lever to reduce this disadvantage is to improve the health situation of lower socioeconomic groups. Our objective is to explore how the considerable within-US variation in health inequalities compares to the health inequalities across other Western countries. Representative survey data from 45 European countries and the US federal states were obtained from the fourth wave of the European Values Study (EVS, 2008) and the 2008 wave of the Behavioral Risk Factor Surveillance System (BRFSS). Using binary logistic regression, we analyze different forms of educational inequalities in self-rated health (SRH), adjusted for age and sex. The extent of educational inequalities in SRH varies considerably over European countries and US states; with US states in general showing greater inequality, however differences between US states and European countries are less clear than commonly assumed. The US have considerable differences in educational inequalities in SRH across geographic locations. To understand the reasons for the US health disadvantage, comparative research has to take into account the vast variation in health inequalities within the US.

scholarly journals Educational Inequalities in Self-Rated Health across US States and European Countries

2019 ◽  
Author(s):  
Patrick Präg ◽  
SV Subramanian
Keyword(s):  
Health Inequalities ◽  
Binary Logistic Regression ◽  
European Countries ◽  
Behavioral Risk ◽  
Educational Inequalities ◽  
Us States ◽  
Federal States ◽  
Self Rated Health ◽  
The Us ◽  
Vast Variation

The US shows a distinct health disadvantage when compared to other high-income nations. A potential lever to reduce this disadvantage is to improve the health situation of lower socioeconomic groups. Our objective is to explore how the considerable within-US variation in health inequalities compares to the health inequalities across other Western countries. Methods: Representative survey data from 44 European countries and the US federal states were obtained from the fourth wave of the European Values Study (EVS) and the 2008 wave of the Behavioral Risk Factor Surveillance System. Using binary logistic regression, we analyze different forms of educational inequalities in self-rated health (SRH), adjusted for age and sex. Results: The extent of educational inequalities in SRH varies considerably over European countries and US states; with US states in general showing greater inequality, however, differences between US states and European countries are less clear than commonly assumed. Conclusions: The US has considerable differences in educational inequalities in SRH across geographic locations. To understand the reasons for the US health disadvantage, comparative research has to take into account the vast variation in health inequalities within the US.

scholarly journals Suicide mortality and its income-based inequalities in Korea, 2005-2017

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Y Kang ◽  
J Bahk ◽  
Y H Khang
Keyword(s):  
Mortality Rate ◽  
Gender Gap ◽  
Global Financial Crisis ◽  
Mortality Rates ◽  
Suicide Mortality ◽  
Relative Inequality ◽  
Relative Index ◽  
Index Of Inequality ◽  
Absolute Inequality ◽  
The Global Financial Crisis

Abstract Backgrounds The suicide mortality rate in Korea has been the highest in the Organization for Economic Co-operation and Development countries between 2003 and 2016. The trends of suicide mortality and its inequalities according to socioeconomic positions provide important information in establishing suicide prevention policies. This study investigated trends in suicide mortality and its income-based inequalities in Korea between 2005 and 2017. Methods Data from 2005-2017 National Health Insurance Database individually linked with cause-of-death data of Statistics Korea were employed. A total of 164,412 suicidal deaths from 574,610,162 subjects aged 10 or over were analyzed. Age-standardized suicide mortality rates were calculated by the calendar year, sex, and income quintiles. The slope index of inequality was calculated as an absolute measure for inequality and relative index of inequality was used as a relative inequality measure. Results The suicide mortality in Korea increased from 29.3 per 100,000 in 2005 to 33.3 in 2011, then decreased to 23.1 in 2017. Suicide mortality rates in men were more than twice as high as the rates in women and the gender gap remained throughout the period. The lower income-level, the higher the suicide mortality rate, especially in men. The absolute inequality in suicide measured by the slope index of inequality has changed as the suicide mortality rate fluctuated, but the relative inequality in suicide has increased since 2012. Conclusions The suicide mortality in Korea has increased due to the global financial crisis and copycat suicide following celebrity suicides in 2008, but it has decreased since the paraquat ban in 2011-12. Despite the recent decline in suicide mortality, the gap between income quintiles did not change meaningfully during the study period. In particular, the magnitude of relative inequality has increased. Progressive national policies should be implemented to reduce suicide mortality and its income gaps. Key messages Despite the recent decline in suicide mortality in Korea, the income-based inequalities in suicide did not change meaningfully. The magnitude of relative inequalities has increased recently.

scholarly journals Life stage-specific trends in educational inequalities in health-related quality of life and self-rated health between 2002 and 2016 in Germany: findings from the German Socio-Economic Panel Study (GSOEP)

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042017
Author(s):  
Stefanie Sperlich ◽  
Marie Kristin Klar ◽  
Batoul Safieddine ◽  
Fabian Tetzlaff ◽  
Juliane Tetzlaff ◽  
...  
Keyword(s):  
Health Inequalities ◽  
Life Stage ◽  
Panel Study ◽  
Working Life ◽  
Educational Inequalities ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Index Of Inequality

ObjectivesWhile evidence suggests persisting health inequalities, research on whether these trends may vary according to different stages of life has rarely been considered. Against this backdrop, we analysed life stage-specific trends in educational inequalities in health-related quality of life (HRQOL) and poor self-rated health (SRH) for individuals in ‘later working life’ (50–64 years), ‘young seniors’ (65–79 years) and persons of ‘old age’ (80+ years).MethodsWe used survey data from the German Socio-Economic Panel Study comprising the period from 2002 to 2016. The sample consists of 26 074 respondents (160 888 person-years) aged 50 years and older. Health was assessed using the mental and physical component summary scale (MCS/PCS) of the HRQOL questionnaire (12-Item Short Form Health Survey V.2) and the single item SRH. To estimate educational health inequalities, we calculated the regression-based Slope Index of Inequality (SII) and Relative Index of Inequality (RII). Time trends in inequalities were assessed by the inclusion of a two-way interaction term between school education and time.ResultsWith increasing age, educational inequalities in PCS and poor SRH decreased whereas they rose in MCS. Over time, health inequalities decreased in men aged 65–79 years (MCSSII=2.76, 95% CI 0.41 to 5.11; MCSRII=1.05, 95% CI 1.01 to 1.10; PCSSII=2.12, 95% CI −0.27to 4.51; PCSRII=1.05, 95% CI 1.00 to 1.11; poor SRHSII=−0.10, 95% CI −0.19 to 0.01; poor SRHRII=0.73, 95% CI 0.48 to 1.13) and among women of that age for MCS (MCSSII=2.82, 95% CI 0.16 to 5.50; MCSRII=1.06, 95% CI 1.01 to 1.12). In contrast, health inequalities widened in the ‘later working life’ among women (PCSSII=−2.98, 95% CI −4.86 to −1.11; PCSRII=0.94, 95% CI 0.90 to 0.98; poor SRHSII=0.07, 95% CI 0.00 to 0.14) while remained largely stable at old age for both genders.ConclusionsWe found distinctive patterns of health inequality trends depending on gender and life stage. Our findings suggest to adopt a differentiated view on health inequality trends and to pursue research that explores their underlying determinants.

scholarly journals Domestic violence and abuse related emergency room visits in Ontario, Canada

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sonica Singhal ◽  
Sarah Orr ◽  
Harkirat Singh ◽  
Menaka Shanmuganantha ◽  
Heather Manson
Keyword(s):  
Domestic Violence ◽  
Emergency Room Visits ◽  
Emergency Rooms ◽  
Relative Index ◽  
Efficient Management ◽  
Dissemination Area ◽  
Icd 10 ◽  
Index Of Inequality ◽  
Policies And Programs ◽  
Domestic Violence And Abuse

Abstract Background Hospitals’ emergency rooms (ERs) are generally the first point of contact of domestic violence and abuse (DVA) victims to the health care system. For efficient management and resource allocation for ERs to manage DVA-related emergencies in Canada, it is important to quantify and assess the pattern of these visits. Methods Aggregate DVA-related ER visits data, using relevant ICD-10-CA codes, from 2012 to 2016 were retrieved from IntelliHealth Ontario. The 2011 ON-Marg (Ontario Marginalization) indices were linked at the Dissemination Area level to ER data. Descriptive analyses including total number and rate of visits per 100,000 people were calculated, stratified by age and sex. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were also assessed. Results From 2012 to 2016, 10,935 (81.2% by females and 18.8% by males) DVA-related visits were made to ERs in Ontario. An annual average of 25.5 visits per 100,000 females and 6.1 visits per 100,000 males was observed. Residential instability and deprivation were significant predictors of DVA-related ER visits. No particular site of injury was indicated in 38.5% of visits, 24.7% presented with cranio-maxillofacial (CMF) trauma in isolation, 28.9% presented with non-CMF injuries, and 7.9% visits presented with both CMF and non-CMF injuries. Conclusion This study identified that the burden of DVA-related ER visits is large enough to warrant timely public health interventions, and observed that certain populations in Ontario experience more DVA and/or are more prone to its impact. Our findings have important implications for various stakeholders involved in planning and implementing relevant policies and programs.

Changes in Family Roles and Subjective Well-Being among Japanese Adults

2021 ◽  
pp. 0192513X2199413
Author(s):  
Yuko Hara
Keyword(s):  
Fixed Effects ◽  
Transition To Parenthood ◽  
Well Being ◽  
Family Roles ◽  
Subjective Well Being ◽  
Men And Women ◽  
Self Rated Health ◽  
Japanese Adults ◽  
Effect Theory ◽  
And Gender

Research in Western countries has demonstrated that marriage is associated with improved well-being, and parenthood with decreased well-being, for both men and women. However, less is known about whether the associations are universal for both genders across countries. Using nine waves of panel data and fixed effects models, this study examines the relationship between changes in family roles and subjective well-being of men and women in the highly gendered social context of Japan. Well-being was assessed across two domains: self-rated health and mental health. The results broadly support the protective effect theory, which posits that marriage itself has a positive effect on well-being; however, no association was observed between becoming a wife and self-rated health. Contrary to what previous research predicts, only men’s self-rated health negatively responds to transition to parenthood. These findings highlight the importance of country context and gender differences in the significance of family obligations.

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