Inequalities in Health

Abstract Background Improving children and young people’s (CYP) health and addressing health inequalities are international priorities. Reducing inequalities is particularly pertinent in light of the Covid-19 outbreak which has exacerbated already widening inequalities in health. This study aimed to explore understandings of inequality, the anticipated pathways for reducing inequalities among CYP and key factors affecting the development and implementation of policy to reduce inequalities among CYP at a local level. Methods We carried out a qualitative case study of one local government region in the North of England (UK), comprising semi structured interviews (n = 16) with service providers with a responsibility for child health, non-participant observations of key meetings (n = 6 with 43 participants) where decisions around child health are made, and a local policy documentation review (n = 11). We employed a novel theoretical framework, drawing together different approaches to understanding policy, to guide our design and analysis. Results Participants in our study understood inequalities in CYP health almost exclusively as socioeconomically patterned inequalities in health practices and outcomes. Strategies which participants perceived to reduce inequalities included: preventive support and early intervention, an early years/whole family focus, targeted working in local areas of high deprivation, organisational integration and whole system/place-based approaches. Despite demonstrating a commitment to a social determinants of health approach, efforts to reduce inequalities were described as thwarted by the prevalence of poverty and budget cuts which hindered the ability of local organisations to work together. Participants critiqued national policy which aimed to reduce inequalities in CYP health for failing to recognise local economic disparities and the interrelated nature of the determinants of health. Conclusions Despite increased calls for a ‘whole systems’ approach to reducing inequalities in health, significant barriers to implementation remain. National governments need to work towards more joined up policy making, which takes into consideration regional disparities, allows for flexibility in interpretation and addresses the different and interrelated social determinants of health. Our findings have particular significance in light of Covid-19 and indicate the need for systems level policy responses and a health in all policies approach.

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Aging and Gender Health Gap: A Multilevel Analysis for 17 European Countries

Social Indicators Research ◽

10.1007/s11205-020-02595-2 ◽

2021 ◽

Author(s):

Patricia Gómez-Costilla ◽

Carmen García-Prieto ◽

Noelia Somarriba-Arechavala

Keyword(s):

Welfare State ◽

Population Group ◽

European Population ◽

European Countries ◽

Gender Inequalities ◽

Eastern European ◽

Inequalities In Health ◽

Social Democratic ◽

Health Gap ◽

Eastern European Countries

AbstractThe European population is aging and their declining capacity makes older Europeans more dependent on the availability of care. Male and female health needs at older ages are different, yet there are contradictory results on the study of gender inequalities in health among the older European population. The aim of this article is twofold: first, we study whether there is a general gender health gap at older ages across Europe. Secondly, we analyze the existence of an increasing or decreasing universal association between the gender health gap and age among the older European population or whether, by contrast, this depends on the type of welfare state. To achieve these goals, we use data from the Survey on Health, Ageing and Retirement in Europe (SHARE) for respondents aged 50 and over in 2015, and we carry out several multilevel random intercept logistic regressions for European countries. Our results show that when we split European countries into groups according to the type of welfare state, we only find a significant gender health gap in older people in Southern and Social Democratic countries. Some differences have been found in the links between the gender health gap and age among European countries. Old women report worse health than men at all ages in Southern countries while in Social Democratic states it is only true for women aged 80 and over. In Bismarckian states there are barely any gender differences, while the gender health gap has no clearly defined bias. Between the ages of 60 and 79, men from Eastern European countries report poorer health, while after 80 it is women who report poorer health. In general, we found the widest gender inequalities in health for the oldest population group, especially in Southern and Eastern European countries.

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