Patterns of health inequalities explained

2019 ◽  
pp. 97-140
Author(s):  
Johan P. Mackenbach
Keyword(s):  
Health Inequalities ◽  
Liberal Democracy ◽  
Health Care Expenditure ◽  
Health Impacts ◽  
Health Determinants ◽  
Educational Expansion ◽  
European Regions ◽  
Socioeconomic Groups ◽  
Highly Educated ◽  
Lower Socioeconomic

Chapter 4 (‘Patterns of health inequalities explained’) is based on in-depth studies of the macro-level determinants of health inequalities, especially conducted for this book. It shows that the persistence of health inequalities is partly due to broader changes in society, such as educational expansion, increasing rates of intergenerational mobility, and more intermarriage of highly educated people. Another factor is that health improvements have been faster in higher than in lower socioeconomic groups, also because higher socioeconomic groups have benefited more from rising prosperity and rising health care expenditure, and have suffered less negative health impacts from rising income inequality and the transition towards liberal democracy in Central and Eastern Europe. Finally, it demonstrates the importance of the continued social patterning of health determinants, particularly poverty and smoking. It ends with a summary of how differences in the magnitude of health inequalities between European regions (North, South, East) should be understood.

The impact of traditional healers on the treatment of psychotic patents in Alexandria, Egypt

2016 ◽  
Vol 33 (S1) ◽  
pp. S399-S399
Author(s):  
S. Darwish
Keyword(s):  
Private Hospital ◽  
Negative Impact ◽  
Traditional Healers ◽  
Psychotic Symptoms ◽  
Socioeconomic Groups ◽  
Highly Educated ◽  
Lower Socioeconomic ◽  
Male Patients ◽  
Competing Interest ◽  
The Impact

IntroductionPsychotic symptoms in the Egyptian community have always been mixed up with supernatural phenomena. This makes patients and their families seek help from traditional healers who can abuse them physically, financially and sexually.AimThe aim of the study was to assess the impact of the traditional healers on the psychotic patients in the Egyptian community.ObjectivesTo measure the percentage of patients going to traditional healers and how much they pay and for how long.MethodsThe study was conducted on a total of 555 psychotic patients. Four hundred and fifty-five psychotic patients from the Mamoura Mental state Hospital and 100 psychotic patients from a private hospital in Alexandria in duration of three months in 2006. A special questionnaire was designed and was run for all patients and their families.ResultsA total of 67.4% of male patients consulted healers while 88.4% of the females consulted healers. Only 9.4% of the females who went to the healers were highly educated compared to 19.7% of the male patients. The majority of the patients who improved were illiterate or can only read and write. Lower socioeconomic groups tend to have a higher percentage in consulting healers and a longer duration of staying in treatment with them. Although therapy at the first session tended to be for free, from the second session forward patients pay more than they would pay seeing a psychiatrist.ConclusionsTraditional healers have a negative impact on the psychiatry practice and are sources of patient's abuse in Egypt.Disclosure of interestThe author has not supplied their declaration of competing interest.

scholarly journals Germany's low SARS-CoV-2 seroprevalence confirms effective containment in 2020: Results of the nationwide RKI-SOEP study

2021 ◽  
Author(s):  
Hannelore Neuhauser ◽  
Angelika Schaffrath Rosario ◽  
Hans Butschalowsky ◽  
Sebastian Haller ◽  
Jens Hoebel ◽  
...  
Keyword(s):  
Infection Prevalence ◽  
Socioeconomic Groups ◽  
Highly Educated ◽  
Educational Group ◽  
Lower Socioeconomic ◽  
Adult Participants ◽  
Seroprevalence Data ◽  
Nasal Swabs ◽  
Educational Groups ◽  
Low Educated

Pre-vaccine SARS-CoV-2 seroprevalence data from Germany are scarce outside hotspots, and socioeconomic disparities remained largely unexplored. The nationwide RKI-SOEP study with 15,122 adult participants investigated seroprevalence and testing in a supplementary wave of the Socio-Economic-Panel conducted predominantly in October-November 2020. Self-collected oral-nasal swabs were PCR-positive in 0.4% and Euroimmun anti-SARS-CoV-2-S1-IgG ELISA from dry capillary blood in 1.3% (95% CI 0.9-1.7%, population-weighted, corrected for sensitivity=0.811, specificity=0.997). Seroprevalence was 1.7% (95% CI 1.2-2.3%) when additionally adjusting for antibody decay. Overall infection prevalence including self-reports was 2.1%. We estimate 45% (95% CI 21-60%) undetected cases and analyses suggest lower detection in socioeconomically deprived districts. Prior SARS-CoV-2 testing was reported by 18% from the lower educational group compared to 25% and 26% from the medium and high educational group (p<0.0001). Symptom-triggered test frequency was similar across educational groups. However, routine testing was more common in low-educated adults, whereas travel-related testing and testing after contact with an infected person was more common in highly educated groups. In conclusion, pre-vaccine SARS-CoV-2-seroprevalence in Germany was very low. Notified cases appear to capture more than half of infections but may underestimate infections in lower socioeconomic groups. These data confirm the successful containment strategy of Germany until winter 2020.

Health inequalities

2019 ◽  
Author(s):  
Johan P. Mackenbach
Keyword(s):  
Social Inequality ◽  
Health Inequalities ◽  
Social Stratification ◽  
Premature Mortality ◽  
Welfare States ◽  
Comprehensive Overview ◽  
Systematic Analysis ◽  
State Reform ◽  
Lower Socioeconomic ◽  
National Governments

‘Health inequalities—persistence and change in European welfare states’ studies why frequencies of disease, disability, and premature mortality are higher among people with a lower socioeconomic position, even in countries with advanced welfare states. Drawing upon data from 30 countries covering more than three decades, it provides a comprehensive overview of trends and patterns of health inequalities, showing that these are not only ubiquitous and persistent, but also highly variable and dynamic. It provides a critical assessment of recent research into the explanation of health inequalities, discussing methodological pitfalls, summarizing findings from epidemiological, sociological, economic, and genetic studies, and reviewing nine overarching theories. Based on in-depth studies of the determinants of health inequalities in European countries, it shows that the persistence of health inequalities is due to a combination of mostly favourable changes in social stratification, massive but differential health improvements, and persistence of social inequality in material and non-material living conditions. It discusses why social inequality is so persistent, and whether welfare state reform could contribute to reducing health inequalities, and provides a systematic analysis of the inequitableness of health inequalities according to five theories of justice. It reviews recent attempts by European national governments to reduce health inequalities, showing that it is realistic to expect evidence-based policies to reduce absolute but not relative inequalities in health. This title is written for scientists and advanced students from various disciplines, as well as for public health professionals and policymakers, and is profusely illustrated and referenced.

scholarly journals Physical inactivity and health inequality during coronavirus: a novel opportunity or total lockdown?

2020 ◽  
Vol 6 (1) ◽  
pp. e000903
Author(s):  
Natalie F Shur ◽  
David Johns ◽  
Stefan Kluzek ◽  
Nicholas Peirce
Keyword(s):  
Public Health ◽  
Health Inequality ◽  
Physical Inactivity ◽  
The Elderly ◽  
Restricted Movement ◽  
Socioeconomic Groups ◽  
Lower Socioeconomic ◽  
The World ◽  
Additional Burden ◽  
Public Health Promotion

Government-restricted movement during the coronavirus pandemic in various countries around the world has led to rapid and fundamental changes in our health behaviour. As well as being at a higher risk of contracting and being hospitalised with COVID-19, the elderly, those with chronic disease and lower socioeconomic groups are also disproportionately affected by restriction of movement, further widening the physical activity health inequality. In this viewpoint we discuss the physiological sequelae of physical inactivity, and the additional burden of ageing and inflammation. We provide recommendations for public health promotion and interventions to try to mitigate the detrimental effects of physical inactivity and rebalance the health inequality.

A Program to Increase Health Care for Children: The Pediatric Nurse Practitioner Program, by Henry K. Silver, MD, Loretta C. Ford, EdD, and Susan G. Stearly, MS, Pediatrics, 1967;39:756–760

PEDIATRICS ◽  
1998 ◽  
Vol 102 (Supplement_1) ◽  
pp. 245-247
Author(s):  
Robert A. Hoekelman
Keyword(s):  
Health Care ◽  
Nurse Practitioner ◽  
Rural Areas ◽  
The United States ◽  
Optimum Level ◽  
Socioeconomic Groups ◽  
Pediatric Nurse ◽  
Lower Socioeconomic ◽  
Urban And Rural Areas ◽  
Pediatric Nurse Practitioner

The increase in population of the United States is occurring at a much more rapid rate than the increase in medical and nursing personnel available to maintain health services at an optimum level. Unless the pattern of furnishing health care, particularly to lower socioeconomic groups in both urban and rural areas, is drastically improved, these groups will suffer from increasingly inadequate health supervision. This paper describes an educational and training program in pediatrics for professional nurses (the “pediatric nurse practitioner” program), which prepares them to assume an expanded role in providing increased health care for children in areas where there are limited facilities for such care.

Who Are Public Bicycle Share Programs Serving? An Evaluation of the Equity of Spatial Access to Bicycle Share Service Areas in Canadian Cities

2018 ◽  
Vol 2672 (36) ◽  
pp. 42-50 ◽  
Author(s):  
Kate Hosford ◽  
Meghan Winters
Keyword(s):  
Service Area ◽  
Spatial Access ◽  
Major Barrier ◽  
Socioeconomic Groups ◽  
Lower Socioeconomic ◽  
Material Component ◽  
Dissemination Area ◽  
Service Areas ◽  
Education Levels ◽  
Substantial Effort

Public bicycle share users are predominantly Caucasian, employed, and have higher incomes and education levels, as compared to the general population. This has prompted bicycle share operators and researchers to increasingly consider equity in bicycle share program access and uptake. The location of bicycle share docking stations has been cited as a major barrier to uptake among lower socioeconomic groups. This study aimed to assess spatial access to bicycle share programs in Canadian cities by comparing the socioeconomic characteristics of dissemination areas inside and outside the bicycle share service areas. We obtained locations of bicycle share stations for the five existing programs in Canada: Vancouver, Hamilton, Toronto, Ottawa-Gatineau, and Montréal. We used the material component of the Pampalon Deprivation Index (2011) as a measure of socioeconomic status for each dissemination area, calculating city-specific quintiles. We compared the distribution of deprivation for dissemination areas inside the bicycle share service area, compared with outside the service area. We found that advantaged areas have better access to bicycle share infrastructure in Vancouver, Toronto, Ottawa-Gatineau, and Montréal, and conversely, that disadvantaged areas have better access in Hamilton. This analysis indicates that in most cities, substantial effort is needed to expand service areas to disadvantaged areas in order to increase spatial access for lower socioeconomic populations.

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