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Journal articles on the topic 'Socioeconomic health gradient'

Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Poulton, Richie, and Avshalom Caspi. "Commentary: Personality and the socioeconomic–health gradient." International Journal of Epidemiology 32, no. 6 (December 2003): 975–77. http://dx.doi.org/10.1093/ije/dyg236.

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Allin, Sara, and Mark Stabile. "Socioeconomic status and child health: what is the role of health care, health conditions, injuries and maternal health?" Health Economics, Policy and Law 7, no. 2 (January 26, 2012): 227–42. http://dx.doi.org/10.1017/s174413311100034x.

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AbstractThere is a persistent relationship between socioeconomic status and health that appears to have its roots in childhood. Not only do children in families with lower income and with mothers with lower levels of education have worse health on average than those with greater socioeconomic advantage, but also the gradient appears to steepen with age. This study contributes to the literature on the relationship between socioeconomic status and child health by testing the hypothesis that the increasing effect of family income on children's health with age relates to the children's use of health care services. It also investigates the role of specific health conditions, injuries or maternal health in explaining the steepening gradient. Drawing on a nationally representative survey from Canada, the National Longitudinal Survey of Children and Youth from the period 1994/95–2008/09, this study provides further evidence of a steepening socioeconomic gradient in child health with age. It finds that accounting for health care use does not explain the steepening gradient and that the protective effect of income appears to be greater for those who had contact with the health system, in particular with regard to physician care and prescription drug use.

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Akkoyun-Farinez, Julie, Abdou Y. Omorou, Johanne Langlois, Elisabeth Spitz, Philip Böhme, Marie-Hélène Quinet, Laura Saez, et al. "Measuring adolescents’ weight socioeconomic gradient using parental socioeconomic position." European Journal of Public Health 28, no. 6 (April 13, 2018): 1097–102. http://dx.doi.org/10.1093/eurpub/cky064.

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De Vogli, Roberto, David Gimeno, Gianni Martini, and Diego Conforti. "The pervasiveness of the socioeconomic gradient of health." European Journal of Epidemiology 22, no. 2 (February 2007): 143–44. http://dx.doi.org/10.1007/s10654-006-9097-7.

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O’Brien, Kymberlee M. "Healthy, wealthy, wise? Psychosocial factors influencing the socioeconomic status–health gradient." Journal of Health Psychology 17, no. 8 (February 7, 2012): 1142–51. http://dx.doi.org/10.1177/1359105311433345.

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Adler, Nancy E., Thomas Boyce, Margaret A. Chesney, Sheldon Cohen, Susan Folkman, Robert L. Kahn, and S. Leonard Syme. "Socioeconomic status and health: The challenge of the gradient." American Psychologist 49, no. 1 (1994): 15–24. http://dx.doi.org/10.1037/0003-066x.49.1.15.

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7

Tanguay-Sabourin, Christophe. "Examining chronic pain through the lens of the socioeconomic gradient." Health Science Inquiry 11, no. 1 (August 10, 2020): 144–47. http://dx.doi.org/10.29173/hsi300.

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Longstanding evidence reveals the existence of a gradient of health running along the socioeconomic spectrum. This is denoted by a graded association between health and levels of socioeconomic status, including factors such as gender, income, education, and occupational roles. This gradient is found across many chronic diseases including heart failure, arthritis, type 2 diabetes, ulcers, and certain cancers, all of which commonly possess debilitating pain diagnoses. Here, I examine chronic pain and its severity through the lens of this socioeconomic gradient across three perspectives along with their potential limitations. First, I discuss how this gradient represents risk factors for greater pain severity, disability, and comorbidity. Then, I explore potential underlying health determinants and how one’s position on this spectrum may predetermine their chance of receiving optimal care for their pain. Finally, I end with the prospect of better clinical and biological understanding of chronic pain severity with the inclusion of this socioeconomic gradient.

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Bonaccio, Marialaura, Augusto Di Castelnuovo, Giovanni de Gaetano, and Licia Iacoviello. "Socioeconomic gradient in health: mind the gap in ‘invisible’ disparities." Annals of Translational Medicine 8, no. 18 (September 2020): 1200. http://dx.doi.org/10.21037/atm.2020.04.46.

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Mensah, George A. "Socioeconomic Status and Heart Health—Time to Tackle the Gradient." JAMA Cardiology 5, no. 8 (August 1, 2020): 908. http://dx.doi.org/10.1001/jamacardio.2020.1471.

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10

Jones, Andrew M., and Stefanie Schurer. "How does heterogeneity shape the socioeconomic gradient in health satisfaction?" Journal of Applied Econometrics 26, no. 4 (December 14, 2009): 549–79. http://dx.doi.org/10.1002/jae.1134.

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Blázquez, Maite, Elena Cottini, and Ainhoa Herrarte. "The socioeconomic gradient in health: how important is material deprivation?" Journal of Economic Inequality 12, no. 2 (May 9, 2013): 239–64. http://dx.doi.org/10.1007/s10888-013-9248-5.

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Khullar, Dhruv, Nicolas M. Oreskovic, James M. Perrin, and Elizabeth Goodman. "Optimism and the Socioeconomic Status Gradient in Adolescent Adiposity." Journal of Adolescent Health 49, no. 5 (November 2011): 553–55. http://dx.doi.org/10.1016/j.jadohealth.2011.04.003.

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13

Mariapun, Jeevitha, Noran N. Hairi, and Chiu-Wan Ng. "Socioeconomic Differences in Smoking and Cessation Across a Period of Rapid Economic Growth in an Upper-Middle-Income Country." Nicotine & Tobacco Research 21, no. 11 (September 25, 2018): 1539–46. http://dx.doi.org/10.1093/ntr/nty203.

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Abstract Introduction Higher smoking rates and lower cessation rates among the poor compared to the rich are evident in high-income countries. In low and middle-income countries (LMICs), many of which are in the early stages of tackling the tobacco epidemic, more knowledge is required of the socioeconomic inequalities in smoking. This is especially the case for upper-middle-income countries, where smoking prevalence is highest. This study examines trends in the socioeconomic gradient in smoking and cessation among adults across a period of rapid economic development in Malaysia, an LMIC with an upper-middle-income economy. Methods The socioeconomic trends in smoking were analyzed using data from cross-sectional National Health and Morbidity Surveys for the years 1996, 2006, and 2011. Household per capita income was used as a measure of socioeconomic position. As a measure of inequality, the concentration index that quantified the degree of socioeconomic inequality in a health outcome was computed. Smoking was assessed in current and former smokers. The study population was examined by gender, region, and age group. Results This study found a trend of an increasingly higher smoking prevalence among the poor and higher cessation rates among the rich. With the exception of younger women in Peninsular Malaysia, the socioeconomic gradient in current smoking is concentrated among the poor. For former smokers, especially men, distributions across the years were mostly concentrated among the rich. Conclusion It is important to ensure that health policies, programs, and interventions consider the potential impact of the socioeconomic patterning in smoking on equity in health. Implications Findings on the socioeconomic gradient in smoking and cessation from Malaysia across a period of rapid economic development will contribute to addressing the paucity of knowledge on the socioeconomic gradient of smoking and cessation in other progressing LMICs. This study provides evidence from an upper-middle-income country, of an increasing trend of smoking among the poor and an increasing trend of cessation rates among the rich, particularly for men. We found opposing trends for younger adult women in the more developed, Peninsular Malaysia. More rich young women were found to have taken up smoking compared to socioeconomically less advantaged young women.

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Ayerga, TJ. "Health In The Triad Of Inequality, Socioeconomic Gradient, And Consumption Pattern." Value in Health 19, no. 3 (May 2016): A132. http://dx.doi.org/10.1016/j.jval.2016.03.546.

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Moloo, J., K. L. Jackson, J. L. Waller, R. E. McKeown, C. L. Addy, S. P. Cuffe, and C. Z. Garrison. "Xenotransmission of the socioeconomic gradient in health? A population based study." BMJ 317, no. 7174 (December 19, 1998): 1686. http://dx.doi.org/10.1136/bmj.317.7174.1686.

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Miller, Ray, Neha Bairoliya, and David Canning. "Health disparities and the socioeconomic gradient in elderly life-cycle consumption." Journal of the Economics of Ageing 14 (2019): 100176. http://dx.doi.org/10.1016/j.jeoa.2018.11.001.

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17

Nurminen, Mikko, Jenni Blomgren, and Hennamari Mikkola. "Socioeconomic differences in utilization of public and private dental care in Finland: Register-based evidence on a population aged 25 and over." PLOS ONE 16, no. 8 (August 4, 2021): e0255126. http://dx.doi.org/10.1371/journal.pone.0255126.

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Dental care utilization is known to have a strong socioeconomic gradient, with lower socioeconomic groups utilizing less of these services despite having poorer dental health. However, less is known about the utilization of dental services in the population concurrently in the public and private sectors in different socioeconomic groups. Additionally, evidence on how different sectors contribute to the overall socioeconomic gradient in dental care utilization is scarce. This study examines visits and absence of visits to public and private dentists in the years 2017–2018 by education, occupational class and income. Comprehensive register data was collected from the total population aged 25 and over in the city of Oulu, Finland (N = 118,397). The data were analyzed with descriptive methods and with multinomial logistic regressions for the probability of visits and with negative binomial regressions for the number of visits, adjusted for sociodemographic covariates. The results showed a clear socioeconomic gradient for the probability of visits according to income and education: the higher the income and the higher the education, the more likely was a visit to a dentist–especially a private dentist–during the two-year period. Similar results were obtained for the number of visits. Higher socioeconomic status was less associated with public dentist visits. While those with the lowest income visited public dentists more frequently than private dentists, their overall visits fell below that of others. Adjusted estimates by occupation did not show a clear socioeconomic gradient. The socioeconomic inequality in dentist visits in a country having a universally covered public dental care scheme puts a challenge for decision makers in designing an equal dental health care system. Experimenting with lower co-payments is a possible option.

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McEniry, Mary, Rafael Samper-Ternent, Carmen Elisa Flórez, Renata Pardo, and Carlos Cano-Gutierrez. "Patterns of SES Health Disparities Among Older Adults in Three Upper Middle- and Two High-Income Countries." Journals of Gerontology: Series B 74, no. 6 (April 19, 2018): e25-e37. http://dx.doi.org/10.1093/geronb/gby050.

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Abstract Objectives To examine the socioeconomic status (SES) health gradient for obesity, diabetes, and hypertension within a diverse group of health outcomes and behaviors among older adults (60+) in upper middle-income countries benchmarked with high-income countries. Method We used data from three upper middle-income settings (Colombia-SABE-Bogotá, Mexico-SAGE, and South Africa-SAGE) and two high-income countries (England-ELSA and US-HRS) to estimate logistic regression models using age, gender, and education to predict health and health behaviors. Results The sharpest gradients appear in middle-income settings but follow expected patterns found in high-income countries for poor self-reported health, functionality, cognitive impairment, and depression. However, weaker gradients appear for obesity, hypertension, diabetes, and other chronic conditions in Colombia and Mexico and the gradient reverses in South Africa. Strong disparities exist in risky health behaviors and in early nutritional status in the middle-income settings. Discussion Rapid demographic and nutritional transitions, urbanization, poor early life conditions, social mobility, negative health behavior, and unique country circumstances provide a useful framework for understanding the SES health gradient in middle-income settings. In contrast with high-income countries, the increasing prevalence of obesity, an important risk factor for chronic conditions and other aspects of health, may ultimately change the SES gradient for diseases in the future.

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Cadar, Dorina, Jessica Abell, Carol Brayne, G. David Batty, David Llewellyn, and Andrew Steptoe. "Biopsychosocial Determinants of Cognitive Health in Later Life: The Harmonised Cognitive Assessment Protocol." Innovation in Aging 4, Supplement_1 (December 1, 2020): 642. http://dx.doi.org/10.1093/geroni/igaa057.2203.

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Abstract Despite strong evidence for a socioeconomic gradient in many health outcomes, including cognition, substantial gaps remain in understanding these disparities. We investigated the biopsychosocial mechanisms underlying the associations between socioeconomic status (SES) and later-life cognitive health using the Harmonised Cognitive Assessment Protocol (HCAP), a sub-study of the English Longitudinal Study of Ageing (ELSA) which comprises of 1,273 ELSA participants aged 65+. A latent g factor was derived using 12 tests covering a broad range of cognitive domains (memory, language, executive function, and psychomotor speed). We estimated direct and indirect pathways between SES indicators, Apolipoprotein E, inflammatory markers, chronic conditions, and depression. We found that higher education was associated with better cognition, while wealth was not. Increased depressive symptoms were linked with lower cognition, while prior inflammation was indirectly associated with cognition via depressive symptoms and chronic conditions, supporting evidence for a psychosocial role in the context of a socioeconomic gradient.

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Mishra, Radhe Shyam, and Sanjay K. Mohanthy. "Socioeconomic and health correlates disability in India." International Journal Of Community Medicine And Public Health 5, no. 2 (January 24, 2018): 600. http://dx.doi.org/10.18203/2394-6040.ijcmph20180236.

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Background: Disabled people suffered from multiple deprivations; poor health, low educational attainment, lower work participation and higher incidence of poverty. With demographic and epidemiological transition, the prevalence of disability also increases. This paper examines the socio economic and health correlates of disability in India. Methods: The unit data from District Level Household Survey (DLHS 4), is used in the analysis. Seven type of disability; namely, mental, visual, hearing, speech, locomotor, multiple, and any disability are analysed. Bi-variate and logistic regression analysis has been used to examine the association between disability and its socioeconomic, health covariates. Results: Prevalence of any disability was 2800 per 100,000 population in India. Prevalence of disability in non-empowered action group (EAG) states was highest for visual (800) followed by locomotor, hearing and mental. Age gradient of disability is quite strong; about 1140 person had any disability by age 10 compared to 3290 by age 40 years. Economic differentials in disability is large. Prevalence of any disability was 3680 among poorest wealth quintile compared to 2540 among richest. Conclusions: Disability was significantly higher in poor, less educated and older adults.

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Shi, Y., M. de Groh, and C. Bancej. "Socioeconomic gradients in cardiovascular risk in Canadian children and adolescents." Health Promotion and Chronic Disease Prevention in Canada 36, no. 2 (February 2016): 21–31. http://dx.doi.org/10.24095/hpcdp.36.2.02.

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Introduction Cardiovascular disease (CVD) and its risk factors show clear socioeconomic gradients in Canadian adults. Whether socioeconomic gradients in cardiovascular risk emerge in childhood remains unclear. The objective of this study was to determine whether there are socioeconomic gradients in physiological markers of CVD risk in Canadian children and adolescents. Methods Using combined cross-sectional data from the Canadian Health Measures Survey 2007–2011, we examined the following cardiovascular risk markers: overweight (including obesity), aerobic fitness score (AFS), blood pressure (BP), blood lipids (total as well as HDL and LDL cholesterol and triglycerides), glucose metabolism and C-reactive protein (CRP) by sex in 2149 children (ages 6–11 years) and 2073 adolescents (ages 12–17 years). Multivariate linear and logistic regression analyses were used to identify patterns in cardiovascular risk across strata of household income adequacy and parental educational attainment, adjusting for age and ethnicity, and stratified by age group and sex. Results Young boys showed markedly higher prevalence of obesity than young girls (prevalence of 18.5%, 95% confidence interval [CI]: 15.6–21.5 vs. 7.7%, 95% CI: 5.2–10.3). However, negative SES gradients in adiposity risk were seen in young and adolescent girls rather than boys. Young and adolescent boys were more physically fit than girls (mean AFS of 541, 95% CI: 534–546 vs. 501, 95% CI: 498–505 in children; 522, 95% CI: 514–529 vs. 460, 95% CI: 454–466 in adolescents; p < .001). Although a positive income gradient in AFS was observed in both boys and girls, statistical significance was reached only in girls (p = .006). A negative gradient of parental education in BP was observed in young children. While we observed substantial sex differences in systolic BP, total and HDL cholesterol, fasting glucose and CRP in adolescents, sex-specific socioeconomic gradients were only observed for systolic BP, HDL and LDL cholesterol. Further studies with large samples are needed to confirm these findings. Conclusion This study identified important sex difference and socioeconomic gradients in adiposity, aerobic fitness and physiological markers of CVD risk in Canadian schoolaged children. Population health interventions to reduce socioeconomic gradients in CVD risk should start in childhood, with a particular focus on preventing obesity in young boys of all SES and girls of low SES, promoting physical fitness especially in girls and in all ages of youth in low-SES groups, and increasing parental awareness, especially those with low educational attainment, of early CVD risks in their children.

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Garrison, S. Mason, and Joseph Lee Rodgers. "Decomposing the causes of the socioeconomic status-health gradient with biometrical modeling." Journal of Personality and Social Psychology 116, no. 6 (June 2019): 1030–47. http://dx.doi.org/10.1037/pspp0000226.

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Hajizadeh, Mohammad, Arnold Mitnitski, and Kenneth Rockwood. "Socioeconomic gradient in health in Canada: Is the gap widening or narrowing?" Health Policy 120, no. 9 (September 2016): 1040–50. http://dx.doi.org/10.1016/j.healthpol.2016.07.019.

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Garrison, S. Mason, and Joseph Lee Rodgers. "Decomposing the Causes of the Socioeconomic Status–Health Gradient with Biometrical Modeling." Multivariate Behavioral Research 52, no. 1 (January 2, 2017): 118–19. http://dx.doi.org/10.1080/00273171.2016.1265434.

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Sanders, Anne E., Gary D. Slade, Gavin Turrell, A. John Spencer, and Wagner Marcenes. "The shape of the socioeconomic-oral health gradient: implications for theoretical explanations." Community Dentistry and Oral Epidemiology 34, no. 4 (August 2006): 310–19. http://dx.doi.org/10.1111/j.1600-0528.2006.00286.x.

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Donat, Marta, Gregorio Barrio, Juan-Miguel Guerras, Lidia Herrero, José Pulido, María-José Belza, and Enrique Regidor. "Educational Gradients in Drinking Amount and Heavy Episodic Drinking among Working-Age Men and Women in Spain." International Journal of Environmental Research and Public Health 19, no. 7 (April 5, 2022): 4371. http://dx.doi.org/10.3390/ijerph19074371.

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Alcohol-related harm decreases as socioeconomic position increases, although sometimes the opposite happens with alcohol intake. The objective was to know the educational gradient in monthly measures of drinking amount and heavy episodic drinking (HED) among people aged 25–64 years in Spain from 1997–2017. Such gradient was characterized with the relative percent change (PC) in drinking measures per year of education from generalized linear regression models after adjusting for age, year, region, marital status and immigration status. Among men, the PCs were significantly positive (p < 0.05) for prevalence of <21 g alcohol/day (2.9%) and 1–3 HED days (1.4%), and they were negative for prevalences of 21–40 g/day (−1.1%), >40 g/day (−6.0%) and ≥4 HED days (−3.2%), while among women they ranged from 3.6% to 5.7%. The gradient in prevalences of >40 g/day (men) and >20 g/day (women) was greatly attenuated after additionally adjusting for HED, while that of ≥4 HED days was only slightly attenuated after additionally adjusting for drinking amount. Among women, the gradients, especially in HED measures, seem steeper in 2009–2017 than in 1997–2007. Educational inequality remained after additional adjustment for income and occupation, although it decreased among women. These results can guide preventive interventions and help explain socioeconomic inequalities in alcohol-related harm.

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Cheng, Mengling, Nicolas Sommet, Daniela Jopp, and Dario Spini. "Socioeconomic Status and Later-Life Health: Longitudinal Evidence From Europe and China." Innovation in Aging 5, Supplement_1 (December 1, 2021): 482. http://dx.doi.org/10.1093/geroni/igab046.1864.

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Abstract Scholars are divided as to how the protective effect of SES on health (the SES-health gradient) varies over the later-life course: The age-as-leveler perspective suggests that the SES-health gradient weakens with age, whereas the cumulative (dis)advantages perspective suggests that it strengthens with age. To clarify this, we used SHARE 2004-2017 (73,407 respondents from 19 European countries) and CHARLS 2011-2018 (8,370 Chinese respondents). Congruent with the age-as-leveler perspective, growth curve models revealed that the overall protective effect of SES on multimorbidity was weaker for older than younger adults (the country-specific effects were significant in two thirds of the case). We interpret this as a selection effect. However, the within-participant protective effect of SES on multimorbidity did not vary over the later-life course (the country-specific effects were nonsignificant in the majority of the case). Findings suggest that extant cross-sectional studies should be interpreted with caution and that longitudinal, cross-national studies are needed.

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Lewis, Hannah, Steven Hope, and Anna Pearce. "Socioeconomic inequalities in parent-reported and teacher-reported psychological well-being." Archives of Disease in Childhood 100, no. 1 (August 27, 2014): 38–41. http://dx.doi.org/10.1136/archdischild-2014-306288.

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ObjectiveTo determine whether there are differences in the social gradient of parent-reported and teacher-reported child psychological well-being.DesignSecondary data analysis comparing ratings of child psychological well-being (Strengths and Difficulties Questionnaire, SDQ) in the UK Millennium Cohort Study at 7 years by socioeconomic circumstances (SEC). A number of measures of SEC were tested; results are reported for maternal education. From a sample of 13 168 singletons who participated at the age of 7 years, complete data were available for 8207 children.ResultsThere was a social gradient in SDQ scores reported by parents and teachers, with ‘borderline/abnormal’ scores more prevalent in children with lower-educated mothers. However, the gradient was more marked in parent report compared with teacher report, and discrepancies between parent and teacher reports were greatest for children from higher SECs.ConclusionsThe social gradient in child psychological well-being, although present, was weaker in teacher report compared with parent report. This may be because children behave differently in school and home settings, or parents and teachers demonstrate reporting bias.

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MADDEN, DAVID. "THE RELATIONSHIP BETWEEN LOW BIRTH WEIGHT AND SOCIOECONOMIC STATUS IN IRELAND." Journal of Biosocial Science 46, no. 2 (April 30, 2013): 248–65. http://dx.doi.org/10.1017/s0021932013000187.

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SummaryThere is now fairly substantial evidence of a socioeconomic gradient in low birth weight for developed countries. The standard summary statistic for this gradient is the concentration index. Using data from the recently published Growing Up in Ireland survey, this paper calculates this index for low birth weight arising from preterm and intrauterine growth retardation. It also carries out a decomposition of this index for the different sources of low birth weight and finds that income inequality appears to be less important for the case of preterm births, while father's education and local environmental conditions appear to be more relevant for intrauterine growth retardation. The application of the standard Blinder–Oaxaca decomposition also indicates that the socioeconomic gradient for low birth weight appears to arise owing to different characteristics between rich and poor, and not because the impact of any given characteristic on low birth weight differs between rich and poor.

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García-Altés, Anna, Dolores Ruiz-Muñoz, Cristina Colls, Montse Mias, and Nicolau Martín Bassols. "Socioeconomic inequalities in health and the use of healthcare services in Catalonia: analysis of the individual data of 7.5 million residents." Journal of Epidemiology and Community Health 72, no. 10 (August 6, 2018): 871–79. http://dx.doi.org/10.1136/jech-2018-210817.

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BackgroundThe aim of this study is to analyse the health status, the use of public healthcare services and the consumption of prescription drugs in the population of Catalonia, taking into consideration the socioeconomic level of individuals and paying special attention to vulnerable groups.MethodsCross-sectional study of the entire population resident in Catalonia in 2015 (7.5 million people) using administrative records. Twenty indicators are analysed related to health, the use of healthcare services and consumption of prescription drugs. Rates, frequencies and averages are obtained for the different variables stratified by age groups (under 15 years, 15–64 years and 65 years or older), gender and socioeconomic status (calculated on the basis of pharmacy copayment levels and Social Security benefits received).ResultsA socioeconomic gradient was observed in all the indicators analysed, in both sexes and in all age groups. Morbidity, use of mental healthcare centres, hospitalisation rates and probability of drug consumption among children is 3–7 times higher for those with low socioeconomic level respect to those with a higher one. In children and adults, the steepest gradient was found in the use of mental health services. Moreover, there are gender inequalities.ConclusionThere are significant socioeconomic inequalities in health status and in the use of healthcare services in the population of Catalonia. To respond to this situation, new policies on health and other areas, such as education and employment, are required, especially those that have an impact on early years.

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Garcia, Raquel, Rosa Abellana, Jordi Real, José-Luis del Val, Jose Maria Verdú-Rotellar, and Miguel-Angel Muñoz. "Health inequalities in hospitalisation and mortality in patients diagnosed with heart failure in a universal healthcare coverage system." Journal of Epidemiology and Community Health 72, no. 9 (June 13, 2018): 845–51. http://dx.doi.org/10.1136/jech-2017-210146.

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BackgroundInformation regarding the effect of social determinants of health on heart failure (HF) community-dwelling patients is scarce. We aimed to analyse the presence of socioeconomic inequalities, and their impact on hospitalisations and mortality, in patients with HF attended in a universal healthcare coverage system.MethodsA retrospective cohort study carried out in patients with HF aged >40 and attended at the 53 primary healthcare centres of the Institut Català de la Salut in Barcelona (Spain). Socioeconomic status (SES) was determined by an aggregated deprivation index (MEDEA). Cox proportional hazard models and competing-risks regression based on Fine and Gray’s proportional subhazards were performed to analyse hospitalisations due to of HF and total mortality that occurred between 1 January 2009 and 31 December 2012.ResultsMean age was 78.1 years (SD 10.2) and 56% were women. Among the 8235 patients included, 19.4% died during the 4 years of follow-up and 27.1% were hospitalised due to HF. A gradient in the risk of hospitalisation was observed according to SES with the highest risk in the lowest socioeconomic group (sHR 1.46, 95% CI 1.27 to 1.68). Nevertheless, overall mortality did not differ among the socioeconomic groups.ConclusionsIn spite of finding a gradient that linked socioeconomic deprivation to an increased risk of hospitalisation, there were no differences in mortality regarding SES in a universal healthcare coverage system.

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Kemp, Blakelee R., and Jennifer Karas Montez. "Why Does the Importance of Education for Health Differ across the United States?" Socius: Sociological Research for a Dynamic World 6 (January 2020): 237802311989954. http://dx.doi.org/10.1177/2378023119899545.

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The positive association between educational attainment and adult health (“the gradient”) is stronger in some areas of the United States than in others. Explanations for the geographic pattern have not been rigorously investigated. Grounded in a contextual and life-course perspective, the aim of this study is to assess childhood circumstances (e.g., childhood health, compulsory schooling laws) and adult circumstances (e.g., wealth, lifestyles, economic policies) as potential explanations. Using data on U.S.-born adults aged 50 to 59 years at baseline ( n = 13,095) and followed for up to 16 years across the 1998 to 2014 waves of the Health and Retirement Study, the authors examined how and why educational gradients in morbidity, functioning, and mortality vary across nine U.S. regions. The findings indicate that the gradient is stronger in some areas than others partly because of geographic differences in childhood socioeconomic conditions and health, but mostly because of geographic differences in adult circumstances such as wealth, lifestyles, and economic and tobacco policies.

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Godefroy, Raphael, and Joshua Lewis. "What explains the socioeconomic status-health gradient? Evidence from workplace COVID-19 infections." SSM - Population Health 18 (June 2022): 101124. http://dx.doi.org/10.1016/j.ssmph.2022.101124.

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Hayward, Mark D., Amy M. Pienta, and Diane K. McLaughlin. "Inequality in Men's Mortality: The Socioeconomic Status Gradient and Geographic Context." Journal of Health and Social Behavior 38, no. 4 (December 1997): 313. http://dx.doi.org/10.2307/2955428.

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Olstad, Dana, Sara Nejatinamini, Charlie Victorino, Sharon Kirkpatrick, Leia Minaker, and Lindsay McLaren. "A Nationally Representative Analysis of Trends in Socioeconomic Inequities in Diet Quality Between 2004 and 2015 Among Adults Living in Canada." Current Developments in Nutrition 5, Supplement_2 (June 2021): 1074. http://dx.doi.org/10.1093/cdn/nzab053_067.

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Abstract Objectives Diet quality is a key determinant of chronic disease and shares a similar socioeconomic patterning. Inequities in diet quality are stable or widening in the US, however these trends have not been examined in other nations. Moreover, prior US studies only examined differences in diet quality between the most and least disadvantaged groups in absolute terms. Quantifying trends in relative terms and along the full socioeconomic gradient according to multiple indicators of socioeconomic position (SEP) can provide a more comprehensive perspective to inform optimal points of intervention. The purpose of this study was to quantify nationally representative trends in absolute and relative gaps and gradients in diet quality between 2004 and 2015 according to three indicators of SEP among adults living in Canada. Methods Adults (≥18 years) who participated in the nationally representative, cross-sectional Canadian Community Health Survey - Nutrition in 2004 (n = 20,880) or 2015 (n = 13,970) were included. SEP was classified based on annual gross household income (quintiles), education (5 categories) and neighborhood deprivation (quintiles). Dietary intake data from interviewer-administered 24-hour recalls were used to derive Healthy Eating Index-2015 scores. Dietary inequities were quantified using four indices: absolute gaps, relative gaps, absolute gradients (slope index of inequality) and relative gradients (relative index of inequality). Sex-stratified multivariable linear regression models examined trends in HEI-2015 scores between 2004 and 2015. Results Mean HEI-2015 scores improved significantly from 55.3 in 2004 to 59.0 in 2015 (maximum 100 points); however these trends were not consistently equitable. While inequities in HEI-2015 scores were stable in females, the absolute gap and gradient in HEI-2015 scores according to household income increased in males, as did the absolute gradient according to education. Conclusions Absolute and relative gaps and gradients in diet quality remained stable or widened between 2004 and 2015 in Canada. Novel policies are needed to tackle these avoidable inequities. Providing universal access to resources with a scale and intensity proportionate to need (i.e., proportionate universalism) may reduce inequities in diet quality and thus, chronic disease risk. Funding Sources Not applicable.

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Barboza Solís DDS, MSc, PhD, Cristina, and Romain Fantin MSc. "The Role of Socioeconomic Position in Determining Tooth Loss in Elderly Costa Rican: Findings from the CRELES Cohort." Odovtos - International Journal of Dental Sciences 19, no. 3 (August 31, 2017): 79. http://dx.doi.org/10.15517/ijds.v19i3.29851.

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Objective: Differences in health status between socioeconomic groups continue to challenge epidemiological research. To evaluate health inequalities in tooth loss, using indicators of socioeconomic position (education level, occupation and subjective economic situation), in a large representative sample of elderly Costa Ricans, can contribute to conceive better adapted public health interventions. Methods: Data are from the Costa Rican Longevity and Healthy Aging Study (CRELES Pre-1945), a longitudinal study of a nationally representative sample of elders. 2827 participants were included in the study using data from the first wave conducted in 2005, and analyzed cross-sectionally. The sample was imputed for missing data using a multiple imputation model. Tooth loss was self-reported and informed about the quantity of missing teeth. Information on participant’s socioeconomic factors was collected via a questionnaire, including three measures approaching socioeconomic position: education level, occupation and subjective economic situation. Additional variables were included in the multivariate analyses as potential confounders. Results: Tooth loss was found to be strongly socially patterned, using variables characterizing socioeconomic position, mainly education level, occupational status and subjective economic situation. Conclusions: To highlight how socioeconomic position relates to tooth loss, can allow a better understanding of the origins of the social gradient in oral health, to tackle the most common chronic diseases across the world.

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Trupin, Laura, Patricia P. Katz, John R. Balmes, Hubert Chen, Edward H. Yelin, Theodore Omachi, and Paul D. Blanc. "Mediators of the Socioeconomic Gradient in Outcomes of Adult Asthma and Rhinitis." American Journal of Public Health 103, no. 2 (February 2013): e31-e38. http://dx.doi.org/10.2105/ajph.2012.300938.

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Case, Anne, Darren Lubotsky, and Christina Paxson. "Economic Status and Health in Childhood: The Origins of the Gradient." American Economic Review 92, no. 5 (November 1, 2002): 1308–34. http://dx.doi.org/10.1257/000282802762024520.

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The well-known positive association between health and income in adulthood has antecedents in childhood. Not only is children's health positively related to household income, but the relationship between household income and children's health becomes more pronounced as children age. Part of the relationship can be explained by the arrival and impact of chronic conditions. Children from lower-income households with chronic conditions have worse health than do those from higher-income households. The adverse health effects of lower income accumulate over children's lives. Part of the intergenerational transmission of socioeconomic status may work through the impact of parents' income on children's health.

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Adler, Nancy E., and Alana Conner Snibbe. "The Role of Psychosocial Processes in Explaining the Gradient Between Socioeconomic Status and Health." Current Directions in Psychological Science 12, no. 4 (August 2003): 119–23. http://dx.doi.org/10.1111/1467-8721.01245.

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The gradient between socioeconomic status (SES) and health is well established: Many measures of health show that health increases as SES increases. However, the mechanisms underlying this association are not well understood. Behavioral, cognitive, and affective tendencies that develop in response to the greater psychosocial stress encountered in low-SES environments may partially mediate the impact of SES on health. Although these tendencies might be helpful for coping in the short term, over time they may contribute to the development of allostatic load, which increases vulnerability to disease. Debate remains regarding the direction of causation between SES and health, the impact of income inequality, the interaction of SES with race-ethnicity and gender, and the effects of SES over the life course.

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Ervasti, Jenni, Mika Kivimäki, Rosemary Dray-Spira, Jenny Head, Marcel Goldberg, Jaana Pentti, Markus Jokela, Jussi Vahtera, Marie Zins, and Marianna Virtanen. "Socioeconomic gradient in work disability in diabetes: evidence from three occupational cohorts." Journal of Epidemiology and Community Health 70, no. 2 (August 20, 2015): 125–31. http://dx.doi.org/10.1136/jech-2015-205943.

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Karlsson, Omar, Rockli Kim, William Joe, and S. V. Subramanian. "Socioeconomic and gender inequalities in neonatal, postneonatal and child mortality in India: a repeated cross-sectional study, 2005–2016." Journal of Epidemiology and Community Health 73, no. 7 (March 28, 2019): 660–67. http://dx.doi.org/10.1136/jech-2018-211569.

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BackgroundIn India, excess female under-5 mortality is well documented. Under-5 mortality is also known to be patterned by socioeconomic factors. This study examines sex differentials and sex-specific wealth gradients in neonatal, postneonatal and child mortality in India.MethodsRepeated cross-sectional study of nationally representative samples of 298 955 children 0–60 months old from the National Family Health Surveys conducted in 2005–2006 and 2015–2016. The study used logistic regression models as well as Cox proportional hazards models.ResultsOverall, boys had greater neonatal mortality than girls and the difference increased between 2005–2006 and 2015–2016. Girls had greater postneonatal and child mortality, but the difference decreased between the surveys and was not statistically significant for child mortality in 2015–2016. A negative wealth gradient was found for all mortality outcomes. Neonatal mortality was persistently greater for boys. Girls had higher child mortality than boys at low levels of wealth and greater postneonatal mortality over much of the wealth distribution. The wealth gradient in neonatal mortality increased between surveys. Females had a stronger wealth gradient than boys for child mortality.ConclusionNot distinguishing between neonatal, postneonatal and child mortality masks important gender-specific and wealth-specific disparities in under-5 mortality in India. Substantial gains towards the Sustainable Development Goals can be made by combating neonatal mortality, especially at low levels of wealth. Although impressive improvements have been made in reducing the female disadvantage in postneonatal and child mortality, concerted engagements are necessary to eliminate the gender gap—especially in poor households and in north India.

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Osborne, Katy, and Katherine Patel. "Evaluation of a website that promotes social connectedness: lessons for equitable e-health promotion." Australian Journal of Primary Health 19, no. 4 (2013): 325. http://dx.doi.org/10.1071/py13038.

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The online provision of health information and services has been viewed as having the potential to inform and empower health consumers and, ultimately, to promote better health. The Internet can be an innovative tool to deliver services to ‘hard-to-reach’ population groups, including geographically isolated populations. However, the online platform raises questions regarding the equitable distribution of health services. In this paper we examine a case study of a website that aims to promote health by fostering social connectedness. The website provides information to connect people to locally based community events across Australia. We draw on evaluation findings to examine the socioeconomic and geographical distribution of website usage. A descriptive analysis of web usage statistics revealed a gradient whereby more information is listed and viewed about events in affluent socioeconomic areas. Furthermore, the analysis showed that a greater proportion of information listed and viewed related to urban areas. These results are consistent with broader gradients of Internet access and usage. Drawing on these findings, we identify implications for online health promotion across different population groups, particularly for interventions that do not incorporate an explicit equity focus.

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Fosse, Elisabeth, Nigel Sherriff, and Marit Helgesen. "Leveling the Social Gradient in Health at the Local Level: Applying the Gradient Equity Lens to Norwegian Local Public Health Policy." International Journal of Health Services 49, no. 3 (April 23, 2019): 538–54. http://dx.doi.org/10.1177/0020731419842518.

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The gradient in health inequalities reflects a relationship between health and social circumstance demonstrating that health worsens as you move down the socioeconomic scale. Norway’s Public Health Act (PHA) specifically aims to tackle the gradient by addressing the social determinants of health. In this article, we draw on data from 2 studies that investigated how municipalities in Norway deal with these challenges. In doing so, we apply theoretical perspectives, as defined in the Gradient Evaluation Framework (GEF), to analyze the implementation of the PHA at the municipality level. The article aims to describe and analyze how local governments follow the requirements of the act. In doing so, we address the following research questions: Which policies are implemented at the local level to reduce social inequalities in health among families and children? How is intersectoral collaboration carried out, and who is taking part in the collaboration? The article draws on both quantitative survey data from questionnaires sent to all Norwegian municipalities and qualitative interview data in 6 municipalities. The findings show that there is raised awareness of the significance of social determinants among an increased number of municipalities, indicating that the PHA is being implemented according to its objectives.

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Qin, Min, Maria Evandrou, Jane Falkingham, and Athina Vlachantoni. "Did the Socio-Economic Gradient in Depression in Later-Life Deteriorate or Weaken during the COVID-19 Pandemic? New Evidence from England Using Path Analysis." International Journal of Environmental Research and Public Health 19, no. 11 (May 30, 2022): 6700. http://dx.doi.org/10.3390/ijerph19116700.

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It is well established that there is a socioeconomic gradient in adult mental health. However, little is known about whether and how this gradient has been exacerbated or mitigated by the COVID-19 pandemic. This study aims to identify the modifiable pathways involved in the association between socioeconomic position (SEP) and mental health during the COVID-19 pandemic. The analysis included 5107 adults aged 50+ living in England and participating in the English Longitudinal Study of Ageing Wave nine (2018–2019) and the COVID-19 study (June 2020). Mental health was measured using a shortened version of the Centre for Epidemiologic Studies Depression scale. Path analysis with multiple mediator models was used to estimate the direct effect of SEP (measured by educational qualification and household wealth) on mental health (measured by depression), along with the indirect effects of SEP via three mediators: COVID-19 infection symptoms, service accessibility and social contact. The results show that the prevalence of depression for the same cohort increased from 12.6% pre-pandemic to 19.7% during the first wave of the pandemic. The risk of depression increased amongst older people who experienced COVID-19 infection, difficulties accessing services and less frequent social contact. The total effects of education and wealth on depression were negatively significant. Through mediators, wealth and education were indirectly associated with depression. Wealth also directly affected the outcome. The findings suggest that the socioeconomic gradient in depression among older people may have deteriorated during the initial phase of the pandemic and that this could in part be explained by increased financial hardship, difficulties in accessing services and reduced social contact.

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Borga, Liyousew G., Daniel Münich, and Lubomir Kukla. "The socioeconomic gradient in child health and noncognitive skills: Evidence from the Czech Republic." Economics & Human Biology 43 (December 2021): 101075. http://dx.doi.org/10.1016/j.ehb.2021.101075.

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Joe, William, and Sunil Rajpal. "Unravelling the socioeconomic gradient in the incidence of catastrophic health care expenditure: a comment." Health Policy and Planning 33, no. 5 (March 30, 2018): 699–701. http://dx.doi.org/10.1093/heapol/czy026.

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Pitel, Lukas, Andrea Madarasova Geckova, Sijmen A. Reijneveld, and Jitse P. van Dijk. "Socioeconomic gradient shifts in health-related behaviour among Slovak adolescents between 1998 and 2006." International Journal of Public Health 58, no. 2 (June 27, 2012): 171–76. http://dx.doi.org/10.1007/s00038-012-0382-9.

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Evans, Gary W., and Pilyoung Kim. "Multiple risk exposure as a potential explanatory mechanism for the socioeconomic status-health gradient." Annals of the New York Academy of Sciences 1186, no. 1 (February 2010): 174–89. http://dx.doi.org/10.1111/j.1749-6632.2009.05336.x.

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Szwarcwald, Célia Landmann, Paulo Roberto Borges de Souza-Júnior, Maria Angela Pires Esteves, Giseli Nogueira Damacena, and Francisco Viacava. "Socio-demographic determinants of self-rated health in Brazil." Cadernos de Saúde Pública 21, suppl 1 (2005): S54—S64. http://dx.doi.org/10.1590/s0102-311x2005000700007.

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Self-rated health has been used extensively in epidemiologic studies, not only due to its importance per se but also due to the validity established by its association with clinical conditions and with greater risk of subsequent morbidity and mortality. In this study, the socio-demographic determinants of good self-rated health are analyzed using data from the World Health Survey, adapted and carried out in Brazil in 2003. Logistic regression models were used, with age and sex as covariables, and educational level, a household assets index, and work-related indicators as measures of socioeconomic status. Besides the effects of sex and age, with consistently worst health perception among females and among the eldest, the results showed pronounced socioeconomic inequalities. After adjusting for age, among females the factors that contributed most to deterioration of health perception were incomplete education and material hardship; among males, besides material hardship, work related indicators (manual work, unemployment, work retirement or incapable to work) were also important determining factors. Among individuals with long-term illness or disability, the socioeconomic gradient persisted, although of smaller magnitude.

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Wagener, D. K., and A. Schatzkin. "Temporal trends in the socioeconomic gradient for breast cancer mortality among US women." American Journal of Public Health 84, no. 6 (June 1994): 1003–6. http://dx.doi.org/10.2105/ajph.84.6.1003.

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