Pandemic inequalities: emerging infectious diseases and health equity

The frequency and scale of Emerging Infectious Diseases (EIDs) with pandemic potential has been increasing over the last two decades and, as COVID-19 has shown, such zoonotic spill-over events are an increasing threat to public health globally. There has been considerable research into EIDs – especially in the case of COVID-19. However, most of this has focused on disease emergence, symptom identification, chains of transmission, case prevalence and mortality as well as prevention and treatment. Much less attention has been paid to health equity concerns and the relationship between socio-economic inequalities and the spread, scale and resolution of EID pandemics. This commentary article therefore explores socio-economic inequalities in the nature of EID pandemics. Drawing on three diverse case studies (Zika, Ebola, COVID-19), it hypothesises the four main pathways linking inequality and infectious disease (unequal exposure, unequal transmission, unequal susceptibility, unequal treatment) – setting out a new model for understanding EIDs and health inequalities. It concludes by considering the research directions and policy actions needed to reduce inequalities in future EID outbreaks.

Socio-economic inequalities in adolescent mental health in the UK: multiple socio-economic indicators and reporter effects

There are socio-economic inequalities in the experience of mental ill-health. However, less is known about the extent of inequalities by different indicators of socio-economic position (SEP). This is relevant for insights into the mechanisms by which these inequalities arise. For young people's mental health there is an additional layer of complexity provided by the widespread use of proxy reporters. Using data from the UK Millennium Cohort Study (N=10,969), we investigated the extent to which five objective SEP indicators (parent education, household income, household wealth, parent occupational status, and relative neighbourhood deprivation) predict adolescent internalising mental health and how this varies as a function of reporter. Both parent report and adolescent self-report were considered. Regression models demonstrated that whilst all five SEP indicators were associated with parent-reported adolescent mental health (regression coefficients for the most disadvantaged groups and adolescent mental health: parent education β=0.53 [0.44;0.62], household income β=0.56 [0.50;0.62], household wealth β=0.18 [0.10;0.27], parent occupational status β=0.40 [0.35;0.46], and relative neighbourhood deprivation β=0.41 [0.33;0.49]), only income (β=0.11 [0.04;0.17]), wealth (β=0.12 [0.02;0.21]), and occupational status (β=0.08 [0.03;0.13]) were associated with self-reported mental health. The magnitude of these effects was greater for parent-reported than self-reported adolescent internalising symptoms: SEP indicators jointly predicted 5.2% of the variance in parent-reported compared to 1.4% of the variance in self-reported internalising mental health. Income predicted the most variance in both parent (4.2% variance) and self-reported internalising symptoms (0.5% variance). Interestingly, the gradient of parent-reported adolescent mental health across SEP indicators mirrors that of parent's own mental health (for example, income predicted 7.3% variance). Our findings highlight that the relevance of different SEP indicators to adolescent internalising mental health differs between parent and adolescent reports. Therefore, it is important to consider the various perspectives of mental health inequalities gained from different types of reporters.

Socio-Economic Inequalities in Lung Cancer Outcomes: An Overview of Systematic Reviews

In the past decade, evidence has accumulated about socio-economic inequalities in very diverse lung cancer outcomes. To better understand the global effects of socio-economic factors in lung cancer, we conducted an overview of systematic reviews. Four databases were searched for systematic reviews reporting on the relationship between measures of socio-economic status (SES) (individual or area-based) and diverse lung cancer outcomes, including epidemiological indicators and diagnosis- and treatment-related variables. AMSTAR-2 was used to assess the quality of the selected systematic reviews. Eight systematic reviews based on 220 original studies and 8 different indicators were identified. Compared to people with a high SES, people with a lower SES appear to be more likely to develop and die from lung cancer. People with lower SES also have lower cancer survival, most likely due to the lower likelihood of receiving both traditional and next-generation treatments, higher rates of comorbidities, and the higher likelihood of being admitted as emergency. People with a lower SES are generally not diagnosed at later stages, but this may change after broader implementation of lung cancer screening, as early evidence suggests that there may be socio-economic inequalities in its use.

What Are the Potential Impacts of a Global Health Crisis on Economic Inequalities in Some Countries?

This study investigates the relationship between the COVID-19 crisis and economic inequalities in some developed and developing countries. Many institutions, like OECD, ILO, and UNDP, have released several reports deal with the relationship between COVID-19 and different kinds of inequalities. These reports generally emphasize the same problem. This study includes some indicators about the situation of education and gender inequalities in OECD countries. These indicators purely reveal that COVID-19 has negative effects on both education and gender inequalities in most of developed and developing countries. The main contribution of the study is to point out the importance of recovery policies the cover the inequality problems.

Dynasties in the making: Family wealth and inheritance for the first-generation ultra-wealthy and their wealth managers

The inheritance practices of the ultra-wealthy play a key role in reproducing socio-economic inequalities across generations. Given this role, we need a better understanding of the individuals and families who own, accumulate and pass on substantial amounts of wealth. This article asks two questions: first, how do parents with profound ownership or control over capital reconcile cultivating dynastic wealth with beliefs in meritocratic achievement? And, second, how do wealth managers justify their commercial value to first generation wealthy clients? The answer to both of these questions involves what I call a pedagogy of inherited wealth. Drawing on semi-structured interviews with first-generation ultra-wealthy parents and their wealth managers, it documents how wealthy parents and wealth managers construct risky futures around inheritance, and their strategies to manage those risks through the control of access to the family’s wealth. In doing so, it explores how they produce two roles, termed here the ‘good inheritor’ and the ‘good client’. Through examining various strategies to manage family wealth and inheritance, the article reveals the legitimating and enabling pedagogy surrounding this process and the paradox at the heart of this pedagogy – which promotes both the value of work among the next generation of inheritors and the preservation of dynastic wealth that will preclude their dependence on income-generating work.

Missions in Contested Places/Spaces: The SPG, Slavery, and Codrington College, Barbados

Mentioning the Society for the Propagation of the Gospel, a seminary, and slavery in the same breath seems incongruous. Nonetheless, within the account of Codrington College, Barbados, the Anglican Communion’s first theological college, we find these three inextricably linked. Using a historical-analytical approach, this paper reveals the troubling missionizing principles which advanced oppressive colonial structures, while failing to fully develop the personhood, agency, and full emancipation of the oppressed. We reassess the ways that particular top-down framings of Christianity and missions were used to enslave/oppress Afro-Barbadians, even under the guise of emancipation. Advocating instead for a framework centering emancipation from below, we outline the ways in which this historical account provides insight for contemporary missional hermeneutics/praxis that seeks to uproot racial and economic inequalities, thus pursuing liberation for all.

Adult life-course trajectories of psychological distress and economic outcomes in midlife during the COVID-19 pandemic

This study used two British birth cohorts to examine whether pre-pandemic trajectories of psychological distress were associated with a greater risk of changes in financial and employment situation during the pandemic, as well as increased need for government support and use of other methods to mitigate their economic situation. We identified 5 differential life-course trajectories of psychological distress from adolescence to midlife and explored their relation to changes in financial and employment circumstances at different stages during the pandemic from May 2020 to March 2021, applying multinomial logistic regression and controlling for numerous early life covariates. In addition, we ran modified Poisson models with robust standard errors to identify whether different trajectories were more likely to have been supported by the benefit system, payment holidays, borrowing and other methods of mitigating the economic shock. We found that despite the UK governments economic response package economic inequalities for pre-pandemic psychological distress trajectories with differential onset, severity and chronicity across the life-course were exacerbated by the COVID-19 economic shock. Furthermore, the subsequent cut in government support, alongside increases in the cost of living may widen economic inequalities for differential pre-pandemic psychological distress trajectories, which in turn may also worsen mental health. This work highlights, different pre-pandemic trajectories of psychological distress were more vulnerable to economic shock.

EKONOMSKA NEJEDNAKOST U VREME PANDEMIJE

In this paper the author presents the overview of the impact of the Covid-19 pandemic on the global economic trends with the focus on the economic inequalities. The Covid-19 pandemic that has caused the global recession, has also brought to the surface the issue of global inequalities, particularly exposing the economic inequalities. The Kuznets curve, a scientific achievement in the field of economics, as originally formulated suggests that the level of inequality is low when an economy’s income is at low level, that is, the income inequality increases with economic development and then tends to decline when the country attains a higher income level. However, the sustainability of Kuznets curve is questioned today in the current circumstances of global information society struck by pandemic. Modern economic literature views the contemporary growth of inequality in wealthy countries, as well as in developing countries, through the prism of Kuznets cycles or waves. The growing trend in global inequalities may threaten the attained level of economic growth and scientific and technological progress.

Kemalism and Populism

This article examines the trajectory of populism/halkçilik, one of the least studied principles of Kemalism, from its origins in the ideas of Enlightenment to its practices in modern Turkey. Unlike its commonly perceived negative connotation that is often associated with irrational political objectives, populism is a manifestation of equality premise of Enlightenment. Populism gained popularity among the nineteenth-century American and Russian farmers as well as fin de siècle French intellectuals and politicians. Neither the Russian Narodnik movement nor the American Populist Party were as influential as the French solidarists who were backed by Vatican to carve a middle path between unrefined Capitalism and revolutionary Marxism. Inspired by its earlier counterparts in France and Russia, Kemalist principle of Populism aimed to end inherited socio-economic inequalities that had existed in the former Ottoman Empire. While modern Turkey curbed some inequalities, it has stumbled upon the same core obstacle, unequal distribution of resources. The never-ending human fight for equality will carry on whether it carries the banner of Kemalism or any other ideology.