scholarly journals Using Agent-Based Modeling to Understand the Emergence and Reproduction of Social Inequalities in Health

Proceedings ◽  
2019 ◽  
Vol 44 (1) ◽  
pp. 2
Author(s):  
Javier Alvarez-Galvez ◽  
Victor Suarez-Lledo
Keyword(s):  
Health Outcomes ◽  
Health Inequalities ◽  
Social Inequalities ◽  
Agent Based Modeling ◽  
Poor Health ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
Agent Based ◽  
Individual Determinants ◽  
Combine Evidence

Studies on social inequalities in health present contradictory findings when they attempt to describe and identify the complex societal mechanisms that give rise to poor health outcomes and health inequalities. This work aims to study the mechanism of reproduction of health inequalities among different population groups using agent-based modeling. We combine evidence-based knowledge and survey data to set the simulation model. Our initial findings show that the combination of the most adverse contextual conditions (i.e., negative environmental exposure and the absence of health-care provision) combined with extreme social inequalities in health might increase mortality drastically. The model suggests that, although poor health outcomes may emerge through the action of individual determinants, social inequalities generally emerge and reproduce through non-linear associations and complex multivariate data structures.

scholarly journals Antimicrobial Resistance and Social Inequalities in Health: Considerations of Justice

2020 ◽  
pp. 257-278
Author(s):  
Lynette Reid
Keyword(s):  
Global Health ◽  
Health Inequalities ◽  
Social Inequalities ◽  
Tertiary Care ◽  
Practical Importance ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
Catching Up ◽  
The Impact

Abstract Within-country social inequalities in health have widened while global health inequalities have (with some exceptions) narrowed since the Second World War. On commonly accepted prioritarian and sufficientist views of justice and health, these two trends together would be acceptable: the wealthiest of the wealthy are pulling ahead, but the worst off are catching up and more are achieving sufficiency. Such commitments to priority or sufficiency are compatible with a common “development” narrative about economic and social changes that accompany changes (“transitions”) in population health. I set out a very simple version of health egalitarianism (without commitment to any particular current theory of justice) and focus on two common objections to egalitarianism. Priority and sufficiency both address the levelling down and formalism objections, but these objections are distinct: giving content to equality (I argue here) places in question the claimed normative superiority of priority and sufficiency. Using examples of the role of antimicrobials in both these trends – and the future role of AMR – I clarify (first) the multiple forms and dimensions of justice at play in health, and (second) the different mechanisms at work in generating the two current patterns (seen in life course narratives and narratives of political economy). The “accelerated transition” that narrowed global health inequalities is fed by anti-microbials (among other technology transfers). It did not accelerate but replaced the causal processes by which current HICs achieved the transition (growing and shared economic prosperity and widening political franchise). The impact of AMR on widening social inequalities in health in HICs will be complex: inequality has been fed in part by tertiary care enabled by antimicrobials; AMR might erode the solidarity underlying universal health systems as the well-off seek to maintain current expectations of curative and rehabilitative surgery and chemotherapy while AMR mounts. In light of both speculations about the impact of AMR on social and global health inequalities, I close with practical and with theoretical reflection. I briefly indicate the practical importance of understanding AMR from the perspective of health justice for policy response. Then, from a broader perspective, I argue that the content by which I meet the formalism objection demonstrates that the two trends (broadening within-country inequality and narrowing global inequality) are selective and biased samples of a centuries-long pattern of widening social inequalities in health. We are not in the midst of a process of “catching up”. In light of the long-term pattern described here, is the pursuit of sufficiency or priority morally superior to the pursuit of equality as a response to concrete suffering – or do they rationalize a process more objectively described as the best-off continuing to take the largest share of one of the most important benefits of economic development?

scholarly journals Health inequalities and the welfare state

2009 ◽  
Vol 17 (1) ◽  
Author(s):  
Else-Karin Grøholt ◽  
Espen Dahl ◽  
Jon Ivar Elstad
Keyword(s):  
Welfare State ◽  
Health Inequalities ◽  
Social Inequalities ◽  
Policy Issue ◽  
Doctoral Degree ◽  
Common Denominator ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
Socioeconomic Health Inequalities ◽  
The Welfare State

This issue of the Norwegian Journal of Epidemiology is based on the research conference Health Inequalities and the Welfare State at the Soria Moria Conference Center in Oslo, Norway, October 10-11 2006. The main purpose of the conference was to support, stimulate, disseminate and contribute to research in Norway on social inequalities in health. Nine papers are included in this issue, in addition to this introduction. One paper is based on one of the keynote lectures, while the other eight papers demonstrate some of the themes and approaches in current Norwegian research on socioeconomic health inequalities. Most of the articles have been authored by researchers who are working on a doctoral thesis or have recently attained their doctoral degree. The papers cluster into four groups. One cluster has a common denominator in intervention and policies to reduce health inequalities. A second focuses on marginalised groups, whereas a third cluster draws attention to the possible impact of the social context on individual health. The last paper addresses health inequalities among adolescents. The main focus of the Soria Moria conference was how and why social health inequalities continue to exist in the Norwegian society with a long tradition of a social democratic welfare model. We are pleased to note that health inequalities are becoming a prioritised health policy issue in Norway, and hope this issue of the Norwegian Journal of Epidemiology will contribute to a sharper focus on monitoring of, research on, and interventions to reduce social inequalities in health.

scholarly journals Workshop: Social-to-biological processes over the lifecourse and social inequalities in health

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Systemic Inflammation ◽  
Social Inequalities ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
Biological Responses ◽  
The Social ◽  
The Relationship

Abstract Context Socioeconomic inequalities in health and ageing are observed across contexts and over time, presenting a challenge for public health. The mechanisms driving associations between social conditions and health include biological responses, which in turn are associated with health outcomes. This workshop aims to describe and discuss evidence on the biological embedding of the social environment from research carried out within a large European consortium, and place it within the context of public health. Methods The Lifepath project was funded by the European Commission between 2014-19 and brought together longitudinal datasets from across Europe, as well as an interdisciplinary collective of researchers keen to examine how social inequalities in health are constructed over the lifecourse. Results Four separate studies are presented here. First, Carmeli et al examine the relationship between social position and systemic inflammation through the mediating role of gene regulation. Second, Fraga et al describe the social patterning of chronic inflammation observed in early adolescence. Third, Castagné et al analyse the relationship between social position across the lifecourse and systemic inflammation, and the role of inflammation within the allostatic load heuristic. Fourth, Chadeau-Hyam et al describe social gradients in a multi-system biological health score, and its subsequent relationship with a number of major health outcomes. Discussion We will coordinate a discussion between the audience and workshop participants. The contribution of the inflammatory system to capturing social inequalities and in its association with chronic disease will be discussed. Is it a key player in the construction of health inequalities, or merely an effective signal for many diverse processes? The role biological markers can play in enhancing our understanding of health inequalities, and how the public health community can respond to the evidence will be discussed. Conclusions Socially patterned biological responses begin early in the lifecourse and may be key factors in the construction of social inequalities in health and ageing. As such, they should be taken into account in public health activities and policy. Key messages The biological embodiment of social conditions is observed from early life and across the lifecourse. Systemic inflammation appears to be a central mechanism which is socially patterned and associated with many health outcomes.

scholarly journals Measuring Socioeconomic Position From The Social Inequalities In Health Perspective?: The Case of Costa Rica

2019 ◽  
pp. 143-153 ◽  
Author(s):  
Romain Fantin MSc ◽  
Ingrid Gómez-Duarte MD, MSc, PhD ◽  
Juan Pablo Sáenz-Bonilla MSc ◽  
Karol Rojas-Araya NP ◽  
Cristina Barboza-Solís DDS, MSc, PhD
Keyword(s):  
Costa Rica ◽  
Conceptual Framework ◽  
Health Inequalities ◽  
Socioeconomic Position ◽  
Social Inequalities ◽  
Population Characteristics ◽  
Local Context ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
Advantages And Disadvantages

Introduction: Measuring socioeconomic position (SEP) is central in the analysis of social inequalities in health (SIH). It requires the use of updated instruments, adapted to a particular conceptual framework, taking into account the local context and the population characteristics. This study aims to present and discuss the advantages and disadvantages of different measurement of SEP used in Costa Rica for the analysis of health inequalities.  Materials and methods: A systematic review of the existing instruments and methods used to characterize SEP in Costa Rica was carried out. Results: There is a great diversity of instruments used as proxies of SEP in Costa Rica, both at the individual, and at geographical level. These measures allow to capture specific dimensions of SEP potentially associated with different health outcomes. Being a latent concept, variables approaching SEP should refer to their specific conceptual framework, be adapted to the study design, and population’s characteristics (e.g. age), and should consider the study feasibility of data collection.  Due to the variety and different conceptual frameworks behind each SEP variable, it is not possible to establish the existence of a gold standard. Conclusion: This review of the Costa Rican health inequalities literature regarding SEP instruments, can contribute to a better use of the existing tools. It will allow researchers to better evaluate the instruments that have been previously validated, their respective theoretical frameworks and limitations, to choose the most suitable proxy of SEP for the local context analyzed.

scholarly journals Coronavirus biopolitics: the paradox of France’s Foucauldian heritage

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Mathieu Arminjon ◽  
Régis Marion-Veyron
Keyword(s):  
Health Inequalities ◽  
Social Inequalities ◽  
Short Paper ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
The Past ◽  
The Government

AbstractIn this short paper we analyse some paradoxical aspects of France’s Foucauldian heritage: (1) while several French scholars claim the COVID-19 pandemic is a perfect example of what Foucault called biopolitics, popular reaction instead suggests a biopolitical failure on the part of the government; (2) One of these failures concerns the government’s inability to produce reliable biostatistical data, especially regarding health inequalities in relation to COVID-19. We interrogate whether Foucaldianism contributed, in the past as well today, towards a certain myopia in France regarding biostatistics and its relation to social inequalities in health. One might ask whether this very data could provide an appropriate response to the Foucauldian question: What kind of governance of life is the pandemic revealing to us?

The need for, and value of, a spatial scan statistical tool for tackling social health inequalities

2016 ◽  
Vol 24 (4) ◽  
pp. 99-102 ◽  
Author(s):  
Wahida Kihal ◽  
Cindy Padilla ◽  
Séverine Deguen
Keyword(s):  
Health Inequalities ◽  
Priority Setting ◽  
Social Inequalities ◽  
Developed Countries ◽  
Social Inequalities In Health ◽  
Statistical Tool ◽  
Policy Makers ◽  
Inequalities In Health ◽  
Effective Interventions ◽  
Important Challenge

Today, one important challenge in developed countries is health inequalities. Research conducted in public health policy issues supply little evidence for effective interventions aiming to improve population health and to reduce health inequalities. There is a need for a powerful tool to support priority setting and guide policy makers in their choice of health interventions, and that maximizes social welfare. This paper proposes to divert a spatial tool based on Kulldorff’s scan method to investigate social inequalities in health. This commentary argues that this spatial approach can be a useful tool to tackle social inequalities in health by guiding policy makers at three levels: (i) supporting priority setting and planning a targeted intervention; (ii) choosing actions or interventions which will be performed for the whole population, but with a scale and intensity proportionate to need; and (iii) assessing health equity of public interventions.

scholarly journals Explaining social inequalities in health by sleep: the Japanese civil servants study

2006 ◽  
Vol 28 (1) ◽  
pp. 63-70 ◽  
Author(s):  
M. Sekine ◽  
T. Chandola ◽  
P. Martikainen ◽  
D. McGeoghegan ◽  
M. Marmot ◽  
...  
Keyword(s):  
Social Inequalities ◽  
Civil Servants ◽  
Social Inequalities In Health ◽  
Inequalities In Health
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