scholarly journals Socioeconomic inequality in short birth interval in Ethiopia: a decomposition analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Desalegn Markos Shifti ◽  
Catherine Chojenta ◽  
Elizabeth G. Holliday ◽  
Deborah Loxton
Keyword(s):  
Socioeconomic Status ◽  
Birth Interval ◽  
Concentration Index ◽  
Socioeconomic Inequality ◽  
Child Outcomes ◽  
Decomposition Analysis ◽  
Outcome Variable ◽  
Short Birth Interval ◽  
Related Inequality ◽  
Normalized Concentration

Abstract Background Short birth interval, defined as a birth-to-birth interval less than 33 months, is associated with adverse maternal and child outcomes. Evidence regarding the association of maternal socioeconomic status and short birth interval is inconclusive. Factors contributing to the socioeconomic inequality of short birth interval have also not been investigated. The current study assessed socioeconomic inequality in short birth interval and its contributing factors in Ethiopia. Methods Data from 8448 women collected in the 2016 Ethiopia Demographic and Health survey were included in the study. Socioeconomic inequality in short birth interval was the outcome variable. Erreygers normalized concentration index (ECI) and concentration curves were used to measure and illustrate socioeconomic-related inequality in short birth interval, respectively. Decomposition analysis was performed to identify factors explaining the socioeconomic-related inequality in short birth interval. Results The Erreygers normalized concentration index for short birth interval was − 0.0478 (SE = 0.0062) and differed significantly from zero (P < 0.0001); indicating that short birth interval was more concentrated among the poor. Decomposition analysis indicated that wealth quintiles (74.2%), administrative regions (26.4%), and not listening to the radio (5.6%) were the major contributors to the pro-poor socioeconomic inequalities in short birth interval. Conclusion There was a pro-poor inequality of short birth interval in Ethiopia. Strengthening the implementation of poverty alleviation programs may improve the population’s socioeconomic status and reduce the associated inequality in short birth interval.

scholarly journals Urban-Rural and Gender Differential in Depressive Symptoms Among Elderly in India

2021 ◽  
Author(s):  
Shubham Kumar ◽  
Shekhar Chauhan ◽  
Ratna Patel ◽  
Manish Kumar
Keyword(s):  
Depressive Symptoms ◽  
Urban Areas ◽  
Health Care Services ◽  
Decomposition Analysis ◽  
The Elderly ◽  
Outcome Variable ◽  
Bivariate Analysis ◽  
Related Inequality ◽  
Prevalence Of Depression ◽  
Urban Rural

Abstract Background To date, evidence remained inconclusive explaining rural-urban and male-female differential in depression. Unlike other previous research on the association of several risk factors with depressive symptoms among the elderly, this study focussed on the socio-economic status-related inequality in the prevalence of depression among the elderly along with focussing urban-rural and male-female gradients of depression among the elderly. Methods This study used data from Longitudinal Ageing Study in India (LASI) wave-I, 2017-18, survey. The outcome variable for this study was self-reported depression. Bivariate analysis was used to understand the prevalence by sociodemographic clusters. Fairlie decomposition analysis has been done to measures rural-urban inequalities for depression among older men and women. Results Results found that around 22 percent of urban elderly and 17 percent of rural elderly reported depression. A higher proportion of female elderly (22.6% vs. 18.4%) reported depression than male elderly. Almost one in every five elderly (20.6%) reported depression in India. The results found that a higher percentage of women in rural and urban areas reported depression than their male counterparts. While examining SES-related inequality in the prevalence of depression, education was a significant factor explaining the SES-related inequality in the prevalence of depression among female elderly and not in male elderly. Conclusion Given the large proportion of elderly reporting depression, this study highlights the need for improving health care services among the elderly. The increasing burden of depression in specific sub-populations also highlights the importance of understanding the broader consequences of depression among rural and female elderly.

scholarly journals Decomposing socio-economic inequality for routine medical check-ups among older adults in India

2020 ◽  
Author(s):  
Shobhit Srivast ◽  
Ratna Patel ◽  
Shekhar Chauhan ◽  
Pradeep Kumar ◽  
Samriddhi S Gupte ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Concentration Index ◽  
Early Stage ◽  
Economic Inequality ◽  
Decomposition Analysis ◽  
Policy Formulation ◽  
Health Check ◽  
Substantial Contribution ◽  
Outcome Variable

Abstract BackgroundRoutine medical check-ups not only reduce the health-care costs over time by detecting potentially life-threatening health conditions at an early stage but also reduces the risk of getting sick and thereby increasing the life span and improving overall health. Therefore, this study examined the prevalence and factors associated with medical check-ups among older adults in India.MethodsThe study utilized data from Building a Knowledge Base on Population Aging in India(BKPAI). The routine medical check-up is the outcome variable of this study. Multivariate analysis has been implemented to fulfil the objectives of the study. Concentration index and decomposition analysis were carried out to examine observed socio-economic inequality in the routine medical check-ups.ResultsNearly one-fourth (23.1%) of the older adults were undergoing the routine medical check-up. Older adults with below five years (OR, 1.31; CI: 1.13-1.51), 6 to 10 years (OR, 1.36; CI: 1.16-1.60), and 11+ years of schooling (OR, 2.02; CI: 1.6-2.54) were significantly more likely to go for routine medical check-ups than illiterate older adults. The concentration Index value of 0.19 depicts the pro-rich inequality in health check-ups among older adults. Furthermore, the results from the decomposition analysis revealed that the wealth quintile of the household contributed nearly 57 percent to the observed socio-economic inequality in the prevalence of routine medical check-up. Education and working status of older adults made a substantial contribution to the inequalities in routine medical check-ups and explained 16.9 percent, and 4.2 percent of the total inequality, respectively.ConclusionsFrom a policy perspective, at first, there is a dire need to spread awareness about the usefulness of routine medical check-ups among older adults. Further, this study reflects the association between education and routine medical check-up, and therefore there is a need to promote literacy at the grass-root level; also, it is recommended to promote health literacy among the older adults. A low level of medical check-up among older adults in rural areas could be reduced by offering free health check-ups regularly. Furthermore, the care of the elderly needs to be prioritized while policy formulation.

scholarly journals Socioeconomic inequalities in hypertension in Kenya: a decomposition analysis of 2015 Kenya STEPwise survey on non-communicable diseases risk factors

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Samwel Maina Gatimu ◽  
Thomas Wiswa John
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Socioeconomic Factors ◽  
Body Mass ◽  
Concentration Index ◽  
Socioeconomic Inequality ◽  
Decomposition Analysis ◽  
Socioeconomic Inequalities ◽  
Non Communicable Diseases

Abstract Background One in four Kenyans aged 18–69 years have raised blood pressure. Despite this high prevalence of hypertension and known association between socioeconomic status and hypertension, there is limited understanding of factors explaining inequalities in raised blood pressure in Kenya. Hence, we quantified the socioeconomic inequality in hypertension in Kenya and decomposed the determinants contributing to such inequality. Methods We used data from the 2015 Kenya STEPwise survey for non-communicable diseases risk factors. We included 4422 respondents aged 18–69 years. We estimated the socioeconomic inequality using the concentration index (C) and decomposed the C using Wagstaff decomposition analysis. Results The overall concentration index of hypertension in Kenya was − 0.08 (95% CI: − 0.14, − 0.02; p = 0.005), showing socioeconomic inequalities in hypertension disfavouring the poor population. About half (47.1%) of the pro-rich inequalities in hypertension was explained by body mass index while 26.7% by socioeconomic factors (wealth index (10.4%), education (9.3%) and paid employment (7.0%)) and 17.6% by sociodemographic factors (female gender (10.5%), age (4.3%) and marital status (0.6%)). Regional differences explained 7.1% of the estimated inequality with the Central region alone explaining 6.0% of the observed inequality. Our model explained 99.7% of the estimated socioeconomic inequality in hypertension in Kenya with a small non-explained part of the inequality (− 0.0002). Conclusion The present study shows substantial socioeconomic inequalities in hypertension in Kenya, mainly explained by metabolic risk factors (body mass index), individual health behaviours, and socioeconomic factors. Kenya needs gender- and equity-focused interventions to curb the rising burden of hypertension and inequalities in hypertension.

scholarly journals Socioeconomic Inequality in Colorectal Cancer Stage at Diagnosis Time in Qazvin City during 2014-2016: Concentration Curve Approach

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Ali Qandian ◽  
Pedram Fattahi ◽  
Mojtaba Vand Rajabpour ◽  
Saeed Nemati ◽  
Neda Nasirian ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Socioeconomic Status ◽  
Concentration Index ◽  
Cancer Survival ◽  
Socioeconomic Inequality ◽  
Cancer Staging ◽  
Late Diagnosis ◽  
Iranian Women ◽  
Early Diagnosis Of Cancer ◽  
Diagnosis Of Cancer

Background: The impact of socioeconomic status on cancer survival has already been proven. Early diagnosis of cancer is one of the main reason of this improved survival among high socioeconomic status (SES) people. High SES people are more likely to take part in cancer screening programs for several reason and it seems that diagnosis of cancer is earlier among these people. Despite growing evidence on inequal in cancer survival, diagnosis, and treatment over the past decades there is a lack of evidence on volume and direction of socioeconomic inequality regarding early diagnosis of cancer in Iran. Objectives: To assess socioeconomic inequality in colorectal cancer stage at diagnosis time in Qazvin city, Iran during 2014 - 2016. Methods: A cross-sectional study was conducted on 200 patients who were diagnosed with colorectal cancer (CRC) at the Vellayat hospital of the Qazvin city. The Principal Component Analysis (PCA) approach was used to combine household assets as a proxy of SES. Cancer staging information was extracted from the patient's medical records and then a pathology specialist performed cancer staging. Descriptive statistics and a multiple logistic regression model were used to illustrate an association between CRC late diagnosis and socioeconomic status adjusted for age, sex, and residence of the area. We applied the standardized Concentration Index as a measure of socioeconomic inequality in CRC late diagnosis. Results: The overall percentage of late CRC diagnosis was 40.5% (95% confidence interval (CI) 33.8, 47.5), which was slightly higher among women (47.1%, 95% CI 36.8, 57.6) than men (35.4%, 95% CI, 27.0, 44.7). Logistic regression results spotted an association between SES and the late diagnosis of CRC. In Iranian women, CRC tended to be diagnosed at more advanced stages among the third (Odds Ratio (OR) = 7.68), forth (Low) (OR = 17.86) and fifth (Lowest) (OR = 25.60) SES quintiles, while in men it was only significant for the fifth quintiles (OR = 4.17). Furthermore, the concentration index implied that late CRC diagnosis is concentrated among deprived subgroups in Qazvin city, and it was statistically significant (Overall concentration index = -0.33, 95% CI -0.38, -0.28). It was estimated at -0.35 and -0.29 in Iranian women and men, respectively. Conclusions: According to this survey, CRC tends to be diagnosed at more advanced stages among low socioeconomic status groups, and the observed discrimination is more severe in Iranian women.

scholarly journals Socioeconomic Inequalities in Mental Health in Mongolia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Dorjdagva ◽  
E Batbaatar ◽  
B Dorjsuren ◽  
J Kauhanen
Keyword(s):  
Mental Health ◽  
Marital Status ◽  
Urban Areas ◽  
Concentration Index ◽  
Mental Health Problems ◽  
Socioeconomic Inequality ◽  
Adult Population ◽  
Well Being ◽  
Socioeconomic Inequalities ◽  
Outcome Variable

Abstract Background Promotion of mental health and well-being is recently recognized as a health priority at the global level. In Mongolia, mental health issues have been on the rise. However, less is known on socioeconomic inequality in mental health in the country. The aim of this study is to examine socioeconomic inequality in mental health in the adult population in Mongolia. Methods This study analyzed the data of 30,567 adults from the Household Socio-Economic Survey, collected in 2012 by the National Statistical Office of Mongolia. Self-reported mental health was used as a health outcome variable. Socioeconomic status was measured by household income. We employed the Wagstaff's concentration index to assess the degree of socioeconomic inequality in mental health. Results The results show that the prevalence of self-reported mental health was 1.17% among the respondents. The adults living in urban areas suffer significantly more with mental illness compared to the adults living in rural settlements. The Wagstaff's concentration index for mental health was significantly negative (-0.243), indicating that mental health problems were concentrated among the lower-income groups. The decomposition results show that education, economic activity status and marital status were the main contributors to socioeconomic inequalities in mental health after removing age-sex related contributions. Conclusions Socioeconomic inequality in mental health exists in the adult population in Mongolia, which was mainly explained by the education level, employment and marital status. Prospective policies are needed to reduce socioeconomic inequality in mental health in the country. Key messages Socioeconomic inequality in mental health exists in Mongolia. It calls for further policy actions.

scholarly journals Higher offspring mortality with short interbirth intervals in free-ranging rhesus macaques

2019 ◽  
Vol 116 (13) ◽  
pp. 6057-6062
Author(s):  
D. Susie Lee ◽  
Angelina V. Ruiz-Lambides ◽  
James P. Higham
Keyword(s):  
Birth Interval ◽  
Rhesus Macaques ◽  
Child Outcomes ◽  
Birth Cohorts ◽  
Birth Intervals ◽  
Short Birth Interval ◽  
Birth Records ◽  
Maternal Resources ◽  
Free Ranging ◽  
Offspring Mortality

Short birth intervals have long been linked to adverse child outcomes in humans. However, it remains unclear the extent to which the birth interval has a direct influence on offspring mortality, independent of the confounding effects of modern environments and human sociocultural practices on reproductive behavior. Outside of humans, the relationship between birth intervals and offspring mortality has been rarely tested, leaving an open question of how much the findings from humans imply evolutionarily conserved mechanisms. Here, using ∼9,000 birth records from ∼1,400 free-ranging rhesus macaque mothers, we show that short birth intervals preceding or succeeding the birth of an offspring are both associated with higher offspring mortality, after controlling for heterogeneity across mothers and birth cohorts. We clarify that the mortality risk of a short birth interval to an offspring is contingent on the survival of its older or younger sibling, the condition that reduces maternal resources for investment in the offspring. This finding suggests that life-history tradeoffs between offspring quantity (a short birth interval) and quality (offspring survival) form an evolutionary force shaping variation in birth intervals. Consistent with the well-known observation made in humans, we also found a nonlinear relationship between the preceding interbirth interval and infant mortality. The overall congruence with the findings from the human literature indicates a robust relationship between birth intervals and offspring mortality.

scholarly journals Twelve-year persistence of inequalities in antenatal care utilisation among women in Tanzania: a decomposition analysis of population-based cross-sectional surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e040450
Author(s):  
Deogratius Bintabara ◽  
Namanya Basinda
Keyword(s):  
Antenatal Care ◽  
Concentration Index ◽  
Maternal Education ◽  
Socioeconomic Inequality ◽  
Decomposition Analysis ◽  
Population Based ◽  
Socioeconomic Inequalities ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Cross Sectional

ObjectiveThis study was undertaken to assess the trend and contributors of socioeconomic inequalities in antenatal care (ANC) utilisation among women of reproductive age in Tanzania from 2004 to 2016.DesignPopulation-based cross-sectional surveys.SettingThis study analysed nationally representative data for women of reproductive age obtained from the 2004–2016 Tanzania Demographic Health Surveys.Primary outcome measureThe outcome variables analysed in this study are: (1) attendance of ANC and (2) accessing adequate antenatal care.Analytical methodsThe concentration curve and the concentration index were used to measure socioeconomic inequality in attending and accessing adequate ANC. The concentration index was decomposed to identify the factors explaining the observed socioeconomic inequality of these two outcomes.ResultsThe concentration index for attending at least four ANC visits increased from 0.169 in 2004 to 0.243 in 2016 (p<0.01). Similarly, for accessing adequate care, the index increased from 0.147 in 2004 to 0.355 in 2016 (p<0.01). This indicates the significant increase in socioeconomic inequalities (favouring wealthier women) for these two outcomes over time. Furthermore, the results show that wealth status was the largest contributor to inequality in both attending at least four visits (71%, 50% and 70%) and accessing adequate ANC (50%, 42% and 51%) in 2004, 2010 and 2016, respectively, in favour of wealthier women (p<0.05). The other contributors to socioeconomic inequalities in ANC utilisation were maternal education and type of residence.ConclusionOver the 12 years of surveys, there was no reduction in socioeconomic inequalities in ANC utilisation in Tanzania. Therefore, the efforts of achieving universal health coverage should focus on reducing wealth-related inequality and improving women’s education from poor households.

scholarly journals Predictors of wealth-related inequality in institutional delivery: a decomposition analysis using Nepal multiple Indicator cluster survey (MICS) 2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Umesh Prasad Bhusal
Keyword(s):  
Concentration Index ◽  
Institutional Delivery ◽  
Economic Inequality ◽  
Decomposition Analysis ◽  
Concentration Curve ◽  
Cluster Survey ◽  
Related Inequality ◽  
Multiple Indicator Cluster Survey ◽  
Multiple Indicator ◽  
Status Of Women

Abstract Background Inequality in maternal healthcare use is a major concern for low-and middle-income countries (LMICs). Maternal health indicators at the national level have markedly improved in the last couple of decades in Nepal. However, the progress is not uniform across different population sub-groups. This study aims to identify the determinants of institutional delivery, measure wealth-related inequality, and examine the key components that explain the inequality. Methods Most recent nationally representative Multiple Indicator Cluster Survey (MICS) 2019 was used to extract data about married women (15-49 years) with a live birth within two years preceding the survey. Logistic regression models were employed to assess the association of independent variables with the institutional delivery. The concentration curve (CC) and concentration index (CIX) were used to analyze the inequality in institutional delivery. Wealth index scores were used as a socio-economic variable to rank households. Decomposition was performed to identify the determinants that explain socio-economic inequality. Results The socio-economic status of households to which women belong was a significant predictor of institutional delivery, along with age, parity, four or more ANC visits, education status of women, area of residence, sex of household head, religious belief, and province. The concentration curve was below the line of equality and the relative concentration index (CIX) was 0.097 (p < 0.001), meaning the institutional delivery was disproportionately higher among women from wealthy groups. The decomposition analysis showed the following variables as the most significant contributor to the inequality: wealth status of women (53.20%), education of women (17.02%), residence (8.64%) and ANC visit (6.84%). Conclusions To reduce the existing socio-economic inequality in institutional delivery, health policies and strategies should focus more on poorest and poor quintiles of the population. The strategies should also focus on raising the education level of women especially from the rural and relatively backward province (Province 2). Increasing antenatal care (ANC) coverage through outreach campaigns is likely to increase facility-based delivery and decrease inequality. Monitoring of healthcare indicators at different sub-population levels (for example wealth, residence, province) is key to ensure equitable improvement in health status and achieve universal health coverage (UHC).

scholarly journals Urban-rural and Gender Differential in Depressive Symptoms Among Older Adults in India

2021 ◽  
Author(s):  
Shubham Kumar ◽  
Shekhar Chauhan ◽  
Ratna Patel ◽  
Manish Kumar
Keyword(s):  
Depressive Symptoms ◽  
Urban Areas ◽  
Health Care Services ◽  
Decomposition Analysis ◽  
The Elderly ◽  
Outcome Variable ◽  
Bivariate Analysis ◽  
Related Inequality ◽  
Prevalence Of Depression ◽  
Urban Rural

Abstract Background: To date, evidence remained inconclusive explaining rural-urban and male-female differential in depression. Unlike other previous research on the association of several risk factors with depressive symptoms among the elderly, this study focussed on the socio-economic status-related inequality in the prevalence of depression among the elderly along with focussing urban-rural and male-female gradients of depression among the elderly.Methods: This study used data from Longitudinal Ageing Study in India (LASI) wave-I, 2017-18, survey. The outcome variable for this study was self-reported depression. Bivariate analysis was used to understand the prevalence by sociodemographic clusters. Fairlie decomposition analysis has been done to measures rural-urban inequalities for depression among older men and women.Results: Results found that around 22 percent of urban elderly and 17 percent of rural elderly reported depression. A higher proportion of female elderly (22.6% vs. 18.4%) reported depression than male elderly. Almost one in every five elderly (20.6%) reported depression in India. The results found that a higher percentage of women in rural and urban areas reported depression than their male counterparts. While examining SES-related inequality in the prevalence of depression, education was a significant factor explaining the SES-related inequality in the prevalence of depression among female elderly and not in male elderly.Conclusion: Given the large proportion of elderly reporting depression, this study highlights the need for improving health care services among the elderly. The increasing burden of depression in specific sub-populations also highlights the importance of understanding the broader consequences of depression among rural and female elderly.

Sign in / Sign up

Export Citation Format

Share Document