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 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.

scholarly journals Wider Dental Care Coverage Associated with Lower Oral Health Inequalities: A Comparison Study between Japan and England

2020 ◽  
Vol 17 (15) ◽  
pp. 5539
Author(s):  
Kanade Ito ◽  
Noriko Cable ◽  
Tatsuo Yamamoto ◽  
Kayo Suzuki ◽  
Katsunori Kondo ◽  
...  
Keyword(s):  
Oral Health ◽  
Educational Attainment ◽  
Dental Care ◽  
Social Inequalities ◽  
Health Care Systems ◽  
Relative Index ◽  
Health Related ◽  
Care Systems ◽  
Natural Teeth ◽  
Index Of Inequality

Countries with different oral health care systems may have different levels of oral health related inequalities. We compared the socioeconomic inequalities in oral health among older adults in Japan and England. We used the data for adults aged 65 years or over from Japan (N = 79,707) and England (N = 5115) and estimated absolute inequality (the Slope Index of Inequality, SII) and relative inequality (the Relative Index of Inequality, RII) for edentulism (the condition of having no natural teeth) by educational attainment and income. All analyses were adjusted for sex and age. Overall, 14% of the Japanese subjects and 21% of the English were edentulous. In both Japan and England, lower income and educational attainment were significantly associated with a higher risk of being edentulous. Education-based SII in Japan and England were 9.9% and 26.7%, respectively, and RII were 2.5 and 4.8, respectively. Income-based SII in Japan and England were 9.2% and 14.4%, respectively, and RII were 2.1 and 1.9, respectively. Social inequalities in edentulous individuals exist in both these high-income countries, but Japan, with wider coverage for dental care, had lower levels of inequality than England.

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 Inequitable impact of infection: social gradients in severe COVID-19 outcomes among all confirmed SARS-CoV-2 cases during the first pandemic wave in Sweden

2021 ◽  
pp. jech-2021-216778
Author(s):  
Per E. Gustafsson ◽  
Miguel San Sebastian ◽  
Osvaldo Fonseca-Rodriguez ◽  
Anne-Marie Fors Connolly
Keyword(s):  
Intensive Care ◽  
Social Inequalities ◽  
Cox Regression ◽  
Population Based ◽  
Country Of Birth ◽  
Relative Index ◽  
Case Identification ◽  
Personal Identity Number ◽  
Comorbidity Index ◽  
Index Of Inequality

BackgroundThe backdrop of the ubiquitous social inequalities has increasingly come into foreground in research on the COVID-19 pandemic, but the lack of high-quality population-based studies limits our understanding of the inequitable outcomes of the disease. The present study seeks to estimate social gradients in COVID-19 hospitalisations, intensive care admissions and death by education, income and country of birth, while taking into account disparities in comorbidities.MethodsWe used a register-based retrospective open cohort design enrolling all 74 659 confirmed SARS-CoV-2-positive cases aged >25 years in Sweden during the first wave of the pandemic (until 14 September 2020). Information was retrieved from multiple registers and linked by the unique Swedish personal identity number concerning COVID-19 case identification; COVID-19 hospitalisations, intensive care admissions and death; comorbidities as measured by the Charlson Comorbidity Index; and sociodemographic information. Social gradients were estimated by the Relative Index of Inequality (RII) using Cox regression.ResultsAdjusted analyses showed significant social gradients in COVID-19 hospitalisation, intensive care admission, across education, income and country of birth, which were unaffected by adjustment for comorbidities. Education and country of birth gradients were stronger for hospitalisation and intensive care admissions but small to non-existent for death. In contrast, income gradients were consistent across all three COVID-19 outcomes.ConclusionSocial gradients in severe COVID-19 outcomes are widespread in Sweden, but appear to be unrelated to pre-existing health disparities. Inequitable outcomes of SARS-CoV-2 infection may therefore be at least partially avoidable and could rely on equitable management of confirmed COVID-19 cases.

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.

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