Journal of health inequalities最新文献

{"title":"Patterns of health inequalities explained","authors":"J. Mackenbach","doi":"10.1093/oso/9780198831419.003.0004","DOIUrl":"https://doi.org/10.1093/oso/9780198831419.003.0004","url":null,"abstract":"Chapter 4 (‘Patterns of health inequalities explained’) is based on in-depth studies of the macro-level determinants of health inequalities, especially conducted for this book. It shows that the persistence of health inequalities is partly due to broader changes in society, such as educational expansion, increasing rates of intergenerational mobility, and more intermarriage of highly educated people. Another factor is that health improvements have been faster in higher than in lower socioeconomic groups, also because higher socioeconomic groups have benefited more from rising prosperity and rising health care expenditure, and have suffered less negative health impacts from rising income inequality and the transition towards liberal democracy in Central and Eastern Europe. Finally, it demonstrates the importance of the continued social patterning of health determinants, particularly poverty and smoking. It ends with a summary of how differences in the magnitude of health inequalities between European regions (North, South, East) should be understood.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"215 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73228669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of health inequalities","authors":"J. Mackenbach","doi":"10.1093/oso/9780198831419.003.0002","DOIUrl":"https://doi.org/10.1093/oso/9780198831419.003.0002","url":null,"abstract":"Chapter 2 (‘Patterns of health inequalities’) sets the scene for the rest of the book, by explaining the measurement of health inequalities and by providing a profusely illustrated overview of inequalities in morbidity and mortality by education and occupational class in 30 European countries. It shows that health inequalities are a generalized phenomenon affecting young and old, men and women, and all aspects of health, but with important differences by age, gender, and type of health problem. It shows that health inequalities are present in all European countries, but with striking variations between countries, suggesting that there is great scope for reducing health inequalities. It also shows that although health inequalities are persistent, they are also highly dynamic, with relative inequalities often increasing and absolute inequalities sometimes declining over time. This chapter includes a comparison with other high-income countries (United States, Canada, Australia, New Zealand, Japan, and South Korea).","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87277778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A broader picture","authors":"J. Mackenbach","doi":"10.1093/oso/9780198831419.003.0005","DOIUrl":"https://doi.org/10.1093/oso/9780198831419.003.0005","url":null,"abstract":"Chapter 5 (‘A broader picture’) first discusses why not only health inequalities, but also social inequality is so persistent. After reviewing sociological theories from both the ‘functionalist’ and ‘conflict’ traditions, it chooses a middle road which acknowledges the ineradicable nature of social inequality. It then describes recent trends in welfare state reform, and identifies several areas, such as pensions and active labour market policies, where more attention to health inequalities is required. It also evaluates the common intuition that health inequalities are ‘unjust’, by applying five theories of justice (‘equality of welfare’, ‘capabilities approach’, ‘luck egalitarianism’, ‘justice as fairness’, and ‘equality of opportunity’). It concludes that, although health inequalities are not simply a form of social injustice, there are several compelling reasons to reduce health inequalities, including avoiding accumulation of disadvantage, solidarity with the less well-off, and reducing costs to society.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72389087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Policy implications","authors":"J. Mackenbach","doi":"10.1093/oso/9780198831419.003.0006","DOIUrl":"https://doi.org/10.1093/oso/9780198831419.003.0006","url":null,"abstract":"Chapter 6 (‘Policy implications’) describes how several European countries have tried to reduce health inequalities. Even the well-resourced English strategy (1997–2010) has not reduced health inequalities at the population level, due to a combination of lack of evidence-based interventions and lack of scale of the efforts. Quantitative analyses of actually observed trends in European countries and of the potential impact of equalizing the distribution of risk factors show that reducing relative inequalities in health is almost impossible when overall health improves. It is therefore advisable to aim for reducing absolute inequalities in health, and to avoid overly ambitious quantitative targets. The book ends with a number of partly personal reflections on the sobering conclusions of 30 years of research, but also highlights some new inspirations for continued efforts to reduce health inequalities.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73745105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of alcohol policy in Poland during the transition period","authors":"J. Moskalewicz","doi":"10.5114/jhi.2019.87828","DOIUrl":"https://doi.org/10.5114/jhi.2019.87828","url":null,"abstract":"The 1980s and 1990s witnessed turbulent changes in the social, political, and economic life of Poland. Those changes affected also alcohol consumption, its associated problems, as well as alcohol policy. The Solidarity movement already had on its banners the alcohol question in the early 1980s. The working class apparently blamed the government for pushing alcohol to manipulate drunken society and to discredit its demands for a better life and freedom. In the long series of negotiations between Solidarity and the government a new law on upbringing in sobriety and counteracting alcoholism was adopted in 1982. The law introduced a centralised system of control measures with the aim of restricting alcohol affordability and availability as well as prohibiting alcohol advertising. Compulsory treatment of alcohol dependence was replaced by the so-called obligation to undergo treatment, the aim of which was to liberate the alcohol treatment system of involuntary patients who had to be strictly supervised. By the end of the decade the consumption levelled off at six litres of ethanol per capita annualy, which was moderate by international standards of those times. At the beginning of the transition towards a multi-party political system and market economy the control system was totally rejected as a remnant of socialism, and most restrictions were lifted. Strict rules limiting the number of alcohol outlets were withdrawn. The licensing system was decentralised to a local community level; licensing fees supplied local budgets for upbringing in sobriety and counteracting alcoholism. In that way, local stakeholders of alcohol policy supported the extension of alcohol supply networks in their communities. Their number increased from about 40 thousand in the late 1980s to more than 200 thousand a few years later. The borders became practically open for private importers who claimed that they brought virtually millions of litres for their own use to avoid customs. Privatisation of alcohol industry was followed by numerous scandals but secured an undisturbed flow of alcohol with a substantial share of unrecorded spirits. Recorded consumption figures seemed to be flat. However, problem statistics soared, suggesting a 50% increase in consumption over just a few years. In parallel, the brewing industry expanded its capacity, doubling and then tripling consumption in less than 10 years. The alcohol policy paradigm then fundamentally changed. Alcohol control was replaced by school education and treatment. Available data do not confirm the benefits of this change. The number of people in alcohol treatment doubled, both in outand in-patient units, but alcohol-related mortality did not change. School education seems to fail too, because the prevalence of drinking among 15-16-year-olds doubled and is currently approaching levels recorded among the adult population.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"171 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72443175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"John William Powles obituary (1943-2018)","authors":"C. Brayne, H. Gouda","doi":"10.5114/jhi.2019.87846","DOIUrl":"https://doi.org/10.5114/jhi.2019.87846","url":null,"abstract":"","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"39 1-4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72469177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of maternal secondhand smoke exposure and neonatal outcomes","authors":"M. Parascandola, A. Klein, J. Bromberg","doi":"10.5114/jhi.2019.87838","DOIUrl":"https://doi.org/10.5114/jhi.2019.87838","url":null,"abstract":"Objectives: To determine the risk of adverse pregnancy and foetal outcomes among nonsmoking women exposed to secondhand smoke (SHS) while pregnant and compare the quality of studies in middleand high-income countries (MIC and HIC). Material and methods: To assess the effect of maternal SHS exposure on preterm birth, low birth weight, stillbirth, and orofacial clefts, the authors searched three databases (2004-2015) and applied strict inclusion/exclusion criteria. Crude odds ratios (ORs), adjusted ORs, associated 95% confidence intervals, and raw data were used to estimate pooled ORs using random-effects models. Models were stratified by adjusted/unadjusted data, high study quality vs. low quality, and country income level. Results: The authors identified 39 studies that assessed the effect of maternal SHS exposure on the four outcomes. Of these studies, the 20 conducted in MICs were of lower quality on average than those conducted in HICs. Evidence of a statistically significant effect of SHS exposure was found using adjusted pooled ORs among the high-quality studies for low birth weight (pOR: 1.282 [95% CI: 1.103-1.490]), preterm birth (pOR: 1.290 [95% CI: 1.127-1.476]), and stillbirth (pOR: 1.230 [95% CI: 1.037-1.459]). Using the high-quality adjusted ORs, the effect of SHS exposure in nonsmoking pregnant women on cleft palate with or without cleft lip did not reach significance (pOR: 1.307 [95% CI: 0.893-1.9]). Conclusions: In all analyses, the odds of having negative outcomes were greater among studies conducted in MICs than in HICs. More research is needed in middle-income countries to inform policy and practice.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85388138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One hundred years of health in Poland","authors":"W. Zatoński","doi":"10.5114/jhi.2019.87816","DOIUrl":"https://doi.org/10.5114/jhi.2019.87816","url":null,"abstract":"Life expectancy is the best synthetic indicator for measuring the improvement or deterioration of a country’s health across time. This article charts the life expectancy trends, and their underlying factors, in Poland in the last one hundred years. The process of health gain in Poland has seen much fluctuation. Periods of health convergency with Western Europe have been intertwined with periods of divergency and crisis. The social and economic watershed of 1989 has been followed by a rapid improvement in health indicators. However, the last fifteen years have seen a stalling of the health growth in Poland. Key wOrds: life expectancy, epidemiological transition, Poland, public health, tobacco control, alcohol diseases, diet. Address for correspondence: Witold A. Zatoński, Health Promotion Foundation, 51 Mszczonowska St., 05-830 Nadarzyn, Poland, phone +48 22 378 00 22, e-mail: wazatonski@promocjazdrowia.pl Supplementary materials (slides) are available in Webappendix 2 at the journal’s website: https://www.termedia.pl/Journal/Journal_of_ Health_Inequalities-100. DOI: https://doi.org/10.5114/jhi.2019.87816 IntroductIon The last century has seen a rapid improvement of health indicators around the world. Life expectancy has been historically the best and most useful measure for charting health developments across time and space. This paper analyses the health trends in Poland in the last century through the lens of life expectancy. After World War II we have seen a global convergence of life expectancy trends (see slide 6 in Webappendix 2). In most high-income, politically and economically stable countries a steady increase in life expectancy has been observed. In Poland, and the neighbouring countries of Central and Eastern Europe, the trends in life expectancy have seen much fluctuation. Periods of quick health growth have been intertwined with periods of stalling health improvement, or even its freezing (see slide 6 in Webappendix 2). HumAn development Index Since the early 1990s the United Nations have been using a synthetic measure called the Human Development Index (HDI) to classify the degree of socio-economic development and quality of life in different countries. The HDI allows to make comparisons across countries, and track development through time. The index is composed of three elements – per capita Gross Domestic Income, a measure of education combining average adult years of schooling with expected years of schooling for children, and life expectancy (see slide 6 in Webappendix 2). In the hundred years since Poland regained its independence in 1918 the country has experienced significant improvement in economic and educational attainment [1]. The Polish economists Paweł Bukowski and Wojciech Paczos estimated that in this period Polish GDP rose from EUR 4,000 to EUR 24,000 [2]. They argue that ‘despite wars and crises we are today six times wealthier than our great-grandparents were in 1918 [1]. Most striking are the last three decades, ","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78819853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invisible migrants: A micro-ethnographic account of bodily exhaustion amongst migrant manual labourers working the graveyard shift at New Spitalfields Market in London","authors":"J. MacQuarie","doi":"10.5114/jhi.2019.91400","DOIUrl":"https://doi.org/10.5114/jhi.2019.91400","url":null,"abstract":"This article reports data collected during an ethnographic research project conducted in the New Spitalfields wholesale night market in London. It foregrounds and analyses the portraits of two protagonists and triangulates them with data collected in the wider project. This micro analysis reveals that low-skilled workers (loaders, drivers, cleaners, servers) of the night market engage in physical labour tasks to main-tain a 24/7 city’s economy appetite round-the-clock. The night workers’ somatic experiences, rhythmic bodily labour that constitutes the workers’ bodily capital, are discussed on the backdrop of challenges that they face while working the “graveyard” shift. The paper relays the workers’ individual characteristics, such as the physical and mental abilities to endure and embody the duress of night-shift work. This paper proposes that bodily exhaustion, alienation, and sleep deprivation are amongst the factors causing precarious migrant night workers to become bioautomatons who are awake and working around the clock.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88981625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The alcohol crisis in Polish public health","authors":"W. Zatoński","doi":"10.5114/jhi.2019.91380","DOIUrl":"https://doi.org/10.5114/jhi.2019.91380","url":null,"abstract":"","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90109094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}