Category: Health inequalities

The “double jeopardy” lifestyle effect

How individual and neighbourhood socioeconomic disadvantages jointly affect health-related behaviour

Yinjie Zhu

In our study recently published in the IJE, we found that socioeconomically disadvantaged individuals were more likely to have worse health-related lifestyle behaviour than their neighbours, even if they lived in neighbourhoods with little overall socioeconomic disadvantage.

We also observed a “double jeopardy” effect: an unhealthier lifestyle was found among people with greater individual disadvantage residing in disadvantaged neighbourhoods.

Continue reading “The “double jeopardy” lifestyle effect” →

What the current economic recession means for long-term health outcomes

Kristina Thompson

We are in the midst of a global recession as a result of the COVID-19 pandemic and attendant lockdown measures. Both the pandemic and the lockdown have each, on their own, worsened health outcomes. This fact has been relatively well covered by the media. What is missing from this discussion is that the resulting recession, forecast to be the largest in generations, will itself, in all likelihood, worsen health outcomes among the broader population.

Continue reading “What the current economic recession means for long-term health outcomes” →

Hygiene gaps: between access and practice, and from region to region

Jennyfer Wolf, Richard Johnston, Matthew C Freeman and Annette Prüss-Ustün

Handwashing with soap after faecal contact is key to preventing disease and death from enteric infectious diseases. Our study, recently published in the IJE, is the first to provide global, regional and country estimates of handwashing with soap after potential contact with human faeces, based on representative data on access to handwashing facilities collected for monitoring of the Sustainable Development Goals (SDGs). Our results show that handwashing with soap after using the toilet or other potential contact with human faeces is poorly practised worldwide and that even the necessary equipment – handwashing facilities with soap and water – are inaccessible to billions of people.

Continue reading “Hygiene gaps: between access and practice, and from region to region” →

Junk food in childhood contributes to socioeconomic inequalities in overweight and obesity

Alexandra_Chung_imageAlexandra Chung

Childhood overweight and obesity are a global public health problem. In high-income countries, obesity follows socioeconomic patterns, in that people with a lower socioeconomic position are more likely to be overweight or obese than those with a higher socioeconomic position. Poor diet is a key risk factor for excess weight gain. It is also a risk factor that we can do something about.

Continue reading “Junk food in childhood contributes to socioeconomic inequalities in overweight and obesity” →

Punishing the poor, killing the poor: punitive political responses to economic decline deepen health inequalities in the United States

Elias Nosrati, Michael Ash, Michael Marmot, Martin McKee and Lawrence P King

Nosrati authors

Health inequalities are on the rise in the United States: the gap in life expectancy between those at the top and the bottom of the income spectrum has increased rapidly since the dawn of the century, to the point where the lives of the poor are cut short by up to a decade and a half compared with those of the wealthy. Moreover, while the rich tend to live longer everywhere, life expectancy among the poor varies significantly by geographical region.

In our article recently published in the IJE, we show that these patterns of health are the product of powerful political and economic forces. Over the past few decades, neoliberal politics, the decline of unions and economic globalisation have resulted in rapid industrial restructuring and economic dislocation in the US. Organised labour has been eroded in the industrial heartland, and manufacturing operations have been shifted to the non-unionised south and to foreign countries.

Continue reading “Punishing the poor, killing the poor: punitive political responses to economic decline deepen health inequalities in the United States” →

The relevance of a local cohort: the case for generalisability over representativeness

Eleonora Uphoff, Neil Small, Rosie McEachan and Kate Pickett

For some years, our research has been based in the city of Bradford in northern England. We are often asked to justify our research setting. There seems to be a concern that a cohort population that is not representative of the nation as a whole or of the ‘average person’ cannot produce valuable insights beyond its local setting.

While such concerns are not new, they now seem more present, perhaps due to the rise of Big Data or the increased sharing of and access to data from national surveys and cohorts. Do these reservations represent a push for representativeness and generalisability in epidemiology? If so, this might come at the expense of research aiming to paint a more detailed picture of population health.

Continue reading “The relevance of a local cohort: the case for generalisability over representativeness” →

Smoke exposure in early life and Rheumatic Heart Disease

david-phillipsDavid Phillips

Rheumatic Heart Disease (RHD) is caused by a bacterial (streptococcal) throat infection acquired in childhood.  Although this type of infection is common and widespread, a small proportion of children so affected go on to develop an inflammatory condition that leads to scarring and narrowing of the heart valves and, in time, heart failure. Early on in the course of the disease the joints may be affected – hence the term “rheumatic”.

Still an important disease
At one time Rheumatic Heart Disease was common throughout the UK, Europe and the US; it was the most important cause of heart disease among young adults in Victorian Britain and probably caused the death of Mozart.  Although rare now in most developed countries, it remains an important public health problem in many low and middle income countries. The disease is widespread in the Middle East and Asia, and the the poor indigenous populations of some wealthy countries, for example among Australian Aboriginees and New Zealand Maoris. It is particularly prevalent in sub-Saharan Africa, where it is one of the commonest causes of heart disease, typically affecting children or young adults. There it carries a grim prognosis because of the lack of specialised treatment. Continue reading “Smoke exposure in early life and Rheumatic Heart Disease” →

Did extending compulsory education in the 1950s improve cognitive and emotional outcomes?

Anton LagerLager_Anton_DSC_0051_SIR.jpg

Extending compulsory education from 8 to 9 years had a postive effect on intelligence in our large study of boys exposed to a school reform in Sweden in the 1950s. Extending education benefited sons of farmers and workers most, reducing socioeconomic differences in intelligence. In contrast, the reform seems to have led to reduced emotional control, suggesting that for this outcome alternative activities (e.g. working or attending the old lower secondary school) was better. Continue reading “Did extending compulsory education in the 1950s improve cognitive and emotional outcomes?” →

Are We There Yet? Assessing the Burden of Travel on Maternal Health Care Utilization and Child Mortality in Developing Countries

Mahesh Karra, Günther Fink, David Canning

David Canning Guenther FinkMahesh Karra

 

The problem
Over the past two decades, low- and middle-income countries (LMICs) have made considerable progress towards reducing child mortality. In spite of these achievements, almost six million children under the age of five are estimated to have died in 2015. Many of these deaths could likely be avoided if high quality antenatal care and delivery at health facilities were available to mothers and their children. Yet access to high quality health services remains low in many settings.

Distance to health care facilities has been identified as one of the main potential barriers to health service access. However, while there is strong evidence that long distances to facilities lead to lower utilization of health services, the evidence is less clear about whether long distances to facilities are linked to poor health outcomes. Continue reading “Are We There Yet? Assessing the Burden of Travel on Maternal Health Care Utilization and Child Mortality in Developing Countries” →

Parkinson’s disease and cancer risk: is there a relationship?

Freedman_Michal_2015_ORIG_160x140WEBD. Michal Freedman

Some previous epidemiologic studies have suggested that having Parkinson’s disease decreases your risk of developing cancer, and vice versa. If true, this finding could provide insight into underlying biologic mechanisms for the two diseases.

How we set out to answer the question
In a study published in the International Journal of Epidemiology we used data from Medicare, a U.S. federal health insurance programme for those aged ≥65 years, linked to U.S. cancer registry data to examine the relationship between Parkinson’s disease and cancer. Because we used Medicare data, we were limited to people aged 65 years and older. However, as the Medicare database is very large, we were able to examine relationships in whites and non-whites, in men and women, and in different age groups (all above 65 years).

We hypothesized that previous studies may have found a lower risk of cancer after Parkinson’s disease because cancer screening or medical work-ups were less frequent in people with a debilitating condition such as Parkinson’s than in people without such a condition. Continue reading “Parkinson’s disease and cancer risk: is there a relationship?” →