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Socioeconomic Inequality of Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (15 January 2019) | Viewed by 24577

Special Issue Editors

University of Antwerp, Department of Economics, Antwerp, Belgium; University of Melbourne, Centre for Health Policy, Melbourne, Australia
Interests: socioeconomic inequality of health, history of economic thought, linear models of production
University of Antwerp, Department of Economics & Flemish Research Foundation (FWO), Antwerp, Belgium
Interests: socioeconomic inequality of health, health econometrics, preference measurement, discrete choice experiments

Special Issue Information

Dear Colleagues,

It is a well-documented fact that there exists a positive association between socioeconomic status and health. Put simply: rich people tend to live longer and attain better health outcomes than poor people. Both economists and epidemiologists have done a lot of research on the measurement and explanation of this type of bivariate inequality, leading to an increased understanding of the social gradient. For this special issue, we invite contributions providing new insights into the mechanisms behind socioeconomic inequality of health, as well as contributions focusing on the econometric techniques which could be used to unravel the causal structures and pathways.

Specific avenues of research in socioeconomic inequality of health may include, but are not limited to, the modelling of health dynamics and the assessment of the related inequalities using longitudinal panels of data, the incorporation of risk or uncertainty in future health into the measurement of socioeconomic inequality of health, and the development and evaluation of distribution regression approaches in decomposition analyses. New methodological developments in these areas as well as insightful empirical studies by means of national, regional or global datasets are especially welcome.

Prof. Guido Erreygers
Dr. Roselinde Kessels
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Socioeconomic inequality of health
  • Inequality measurement
  • Inequality decomposition
  • Econometric analysis of inequality
  • Health dynamics modelling
  • Distribution regression approaches

Published Papers (6 papers)

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Research

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28 pages, 1190 KiB  
Article
Distributional Regression Techniques in Socioeconomic Research on the Inequality of Health with an Application on the Relationship between Mental Health and Income
by Alexander Silbersdorff and Kai Sebastian Schneider
Int. J. Environ. Res. Public Health 2019, 16(20), 4009; https://doi.org/10.3390/ijerph16204009 - 19 Oct 2019
Cited by 7 | Viewed by 3184
Abstract
This study addresses the much-discussed issue of the relationship between health and income. In particular, it focuses on the relation between mental health and household income by using generalized additive models of location, scale and shape and thus employing a distributional perspective. Furthermore, [...] Read more.
This study addresses the much-discussed issue of the relationship between health and income. In particular, it focuses on the relation between mental health and household income by using generalized additive models of location, scale and shape and thus employing a distributional perspective. Furthermore, this study aims to give guidelines to applied researchers interested in taking a distributional perspective on health inequalities. In our analysis we use cross-sectional data of the German socioeconomic Panel (SOEP). We find that when not only looking at the expected mental health score of an individual but also at other distributional aspects, like the risk of moderate and severe mental illness, that the relationship between income and mental health is much more pronounced. We thus show that taking a distributional perspective, can add to and indeed enrich the mostly mean-based assessment of existent health inequalities. Full article
(This article belongs to the Special Issue Socioeconomic Inequality of Health)
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15 pages, 337 KiB  
Article
Socioeconomic Differences and the Potential Role of Tribes in Young People’s Food and Drink Purchasing Outside School at Lunchtime
by Ariadne Beatrice Kapetanaki, Wendy J. Wills, Giada Danesi and Neil H. Spencer
Int. J. Environ. Res. Public Health 2019, 16(14), 2447; https://doi.org/10.3390/ijerph16142447 - 10 Jul 2019
Cited by 1 | Viewed by 3162
Abstract
Socioeconomic deprivation has been linked to food consumption practices, but studies investigating the food environment around schools provide mixed findings. Peer influence and marketing cues are considered important influencers of young people’s behaviors. This study used a tribal theory lens to investigate the [...] Read more.
Socioeconomic deprivation has been linked to food consumption practices, but studies investigating the food environment around schools provide mixed findings. Peer influence and marketing cues are considered important influencers of young people’s behaviors. This study used a tribal theory lens to investigate the factors affecting pupils’ purchasing and consumption of food/drinks outside schools at lunchtime. A survey was conducted with 243 pupils from seven UK secondary schools of differing socioeconomic status (SES). A purchasing recall questionnaire (PRQ) was developed and administered online at the participating schools to capture food and drink purchasing, intake, and expenditure. No significant differences were found in terms of energy and nutrients consumed or food/drink expenditure between pupils from schools of lower and higher SES. Enjoyment of food shopping with friends was linked with higher food energy intake and spend. Higher susceptibility to peer influence was associated with greater influence from food advertising and endorsements. Without ignoring the impact that SES can have on young people’s food choices, we suggest that tribal theory can be additionally used to understand pupils’ eating behaviors and we present implications for social marketers and policy makers. Full article
(This article belongs to the Special Issue Socioeconomic Inequality of Health)
14 pages, 544 KiB  
Article
Measuring Socioeconomic Inequalities in Obesity among Korean Adults, 1998–2015
by Jongnam Hwang, Eun-Young Lee and Chung Gun Lee
Int. J. Environ. Res. Public Health 2019, 16(9), 1617; https://doi.org/10.3390/ijerph16091617 - 08 May 2019
Cited by 14 | Viewed by 3693
Abstract
Obesity is a prominent global public health challenge as its prevalence has grown. Even though the increase in prevalence of obesity in Korea has been relatively low, it is expected to continually increase in the next several years, leading to social and economic [...] Read more.
Obesity is a prominent global public health challenge as its prevalence has grown. Even though the increase in prevalence of obesity in Korea has been relatively low, it is expected to continually increase in the next several years, leading to social and economic burdens. This study aimed to assess socioeconomic inequalities in obesity among Korean adults. Using nationally representative survey datasets, the concentration index (CI) and decomposition of the CI were used to capture and quantify obesity-related inequalities from 1998 to 2015. The results suggested that pro-poor inequalities in obesity existed in Korea, indicating that obesity was more concentrated among individuals with lower income. In a gender-stratified model, obesity was more concentrated among women with lower income and men with higher income, showing that the trend and magnitude of inequalities in obesity each vary by gender. The decomposition approach revealed that, over the past 17 years, the main contributors to the existing inequalities were higher education and higher income levels. These findings suggest that comprehensive and multifaceted interventions at the local and national levels should be considered to address the identified income- and education-related barriers with respect to obesity among Korean adults. Full article
(This article belongs to the Special Issue Socioeconomic Inequality of Health)
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12 pages, 868 KiB  
Article
Socioeconomic Inequalities of Undiagnosed Diabetes in a Resource-Poor Setting: Insights from the Cross-Sectional Bangladesh Demographic and Health Survey 2011
by Md. Mehedi Hasan, Fariha Tasnim, Md. Tariqujjaman and Sayem Ahmed
Int. J. Environ. Res. Public Health 2019, 16(1), 115; https://doi.org/10.3390/ijerph16010115 - 03 Jan 2019
Cited by 19 | Viewed by 4637
Abstract
Diabetes mellitus is rising disproportionately but is not frequently diagnosed until complications appear, which results in adverse health consequences. We estimated the prevalence of undiagnosed diabetes among adult diabetic patients and associated socioeconomic inequalities in Bangladesh. We used nationally representative cross-sectional Bangladesh Demographic [...] Read more.
Diabetes mellitus is rising disproportionately but is not frequently diagnosed until complications appear, which results in adverse health consequences. We estimated the prevalence of undiagnosed diabetes among adult diabetic patients and associated socioeconomic inequalities in Bangladesh. We used nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2011 data. Among patients with diabetes, we identified undiagnosed cases as having fasting plasma glucose ≥ 7.0 mmol/L, never having taken prescribed medicine and being told by health professionals. Among 938 patients with diabetes, 53.4% remained undiagnosed. The poorest (75.9%) and rural (59.0%) patients had significantly higher undiagnosed cases than the richest (36.0%) and urban (42.5%), respectively. Multiple logistic regression analysis revealed that the likelihood of being undiagnosed was lower among patients with age ≥ 70 years vs. 35–39 years (adjusted odds ratio (AOR) = 0.35; 95% confidence interval (CI) 0.19, 0.64) and patients with higher education vs. no education (AOR = 0.36; 95% CI 0.21, 0.62). Conversely, a high level of physical activity and being in a poor socioeconomic quintile were associated with a higher risk of remaining undiagnosed for diabetes. The Concentration Index (C) also showed that undiagnosed diabetes was largely distributed among the socioeconomically worse-off group in Bangladesh (C = −0.35). Nationwide diabetes screening programs may reduce this problem in Bangladesh and other similar low-income settings. Full article
(This article belongs to the Special Issue Socioeconomic Inequality of Health)
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13 pages, 290 KiB  
Article
What Explains Education Disparities in Screening Mammography in the United States? A Comparison with The Netherlands
by Hale Koç, Owen O’Donnell and Tom Van Ourti
Int. J. Environ. Res. Public Health 2018, 15(9), 1961; https://doi.org/10.3390/ijerph15091961 - 08 Sep 2018
Cited by 5 | Viewed by 3447
Abstract
Background: In the U.S., less educated women are substantially less likely to receive screening mammography. It is not clear whether this is due to differences in access to screening or in perceptions of breast cancer risks and the effectiveness of screening. We weigh [...] Read more.
Background: In the U.S., less educated women are substantially less likely to receive screening mammography. It is not clear whether this is due to differences in access to screening or in perceptions of breast cancer risks and the effectiveness of screening. We weigh the plausibility of these two explanations by examining how the dependence of mammography on education changes after conditioning on indicators of access and perceptions. We also compare estimates for the U.S. with those for the Netherlands where there is universal access to a publicly financed screening program. Method: Cross-sectional and cross-country comparable individual level data from the American Life Panel (n = 646) and the Netherlands Longitudinal Internet Studies for the Social Sciences (n = 1398) were used to estimate and explain education disparities in screening mammograms given to American and Dutch women aged 40+. The education gradient was estimated using logit models. Controls were sequentially added to detect whether disparities were explained by differences in access or perceptions of risks and effectiveness. Results: In the United States, high school graduates were 11.5 percentage points (95% CI: 1–22 percentage points) less likely than college graduates to receive a screening mammogram in the previous two years. This education gradient was largely explained by differences in income, insurance coverage and receipt of medical advice. It was not explained by educational differences in the perceived risk of breast cancer and the effectiveness of mammography. There were no education disparities in receipt of mammography among Dutch women within the 50–75 age range covered by the national screening program. Conclusion: In the absence of a universal screening program in the U.S., determinants of access—income, insurance coverage and receipt of medical advice—appear to drive the education disparities in screening mammography. Full article
(This article belongs to the Special Issue Socioeconomic Inequality of Health)

Review

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17 pages, 3759 KiB  
Review
Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and Meta-Analysis of Observational Studies
by Simone M. Costa, Carolina C. Martins, Mânia Q. C. Pinto, Mara Vasconcelos and Mauro H. N. G. Abreu
Int. J. Environ. Res. Public Health 2018, 15(8), 1775; https://doi.org/10.3390/ijerph15081775 - 18 Aug 2018
Cited by 56 | Viewed by 5801
Abstract
This study is aimed to perform an update of a systematic review and meta-regression to evaluate the effect modification of the socioeconomic indicators on caries in adults. We included studies that associated social determinants with caries, with no restriction of year and language. [...] Read more.
This study is aimed to perform an update of a systematic review and meta-regression to evaluate the effect modification of the socioeconomic indicators on caries in adults. We included studies that associated social determinants with caries, with no restriction of year and language. The Newcastle-Ottawa Scale was used to evaluate the risk of bias. With regard to the meta-analysis, statistical heterogeneity was evaluated by I2, and the random effect model was used when it was high. A subgroup analysis was conducted for socioeconomic indicators, and a meta-regression was performed. Publication bias was assessed through Egger’s test. Sixty-one studies were included in the systematic review and 25 were included in the meta-analysis. All of the studies were published between 1975 and 2016. The most frequent socioeconomic indicators were schooling, income, and socioeconomic status (SES). In the quantitative analysis, the DMFT (decayed, missing, filled teeth) variation was attributed to the studies’ heterogeneity. The increase of 10.35 units in the proportion of people with lower SES was associated with an increase of one unit in DMFT, p = 0.050. The findings provide evidence that populations with the highest proportions of people with low SES are associated with a greater severity of caries. The results suggest the need for actions to reduce the inequalities in oral health (PROSPERO [CRD42017074434]). Full article
(This article belongs to the Special Issue Socioeconomic Inequality of Health)
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