Differences in employment and income poverty between people with and without disabilities in South Africa

There is a substantial body of literature that confirms the cyclical relationship between poverty and disability. However, while there are studies that have sought to understand the relationship between income poverty and disability and how disability intersects with other factors to influence poverty, most do not offer insight into how this relationship is shaped – particularly given the limited availability of panel data. Furthermore, there is limited research on the effect of social grants and employment on income poverty, as well as how disability intersects with other factors to shape poverty. Guided by the capabilities approach, the focus of this article was therefore on the dynamics of the relationship between disability and two aspects of poverty, namely, income and employment, which are critical to the realization of capabilities. The findings show that people with disabilities in South Africa are more likely to be income poor and remain so over time, but that social grants serve to alleviate income poverty. Income poverty is explained in part by the fact that people with disabilities are less likely to be employed and that when they are employed they face significant wage gaps. Disability also intersects with race, sex and geographic location to shape income poverty in ways that have important implications for policy and programme development.     

Horizontal inequity in the utilisation of healthcare services in Australia

The Australian universal healthcare system aims to ensure affordable and equitable use of healthcare services based on individual health needs. This paper presents empirical evidence on the extent of horizontal inequity (HI) in healthcare services (unequal utilisation by income for equal need) in Australia during the period of promoting reliance on private healthcare financing. Using data from the most recent Australian National Health Survey of 2011−12 and 2014−15, we examined and measured the extent of HI in eight indicators of out-of-hospital services and hospital-related care. Contrary to earlier studies, our results show a small but pro-rich inequity in the probability of general practitioner visits. Inequity in the distribution of specialist and dentist visits was in favour of richer people, a result that is commonly found in other developed countries and is also consistent with existing Australian evidence. Hospital-related care was equitably distributed compared to the pro-poor pattern found in earlier studies. Despite the universal health insurance system in Australia, there was inequity in the utilisation of needed healthcare services. Our evidence is relevant to similar health systems as governments move to higher out-of-pocket payments and other private sources to reduce pressure on public healthcare expenditure.     

Suicide rates across income levels: Retrospective cohort data on 1 million participants collected between 2003 and 2013 in South Korea

Background

The relation of income and socioeconomic status with suicide rates remains unclear. Most previous studies have focused on the relationship between suicide rates and macroeconomic factors (e.g., economic growth rate). Therefore, we aimed to identify the relationship between individuals' socioeconomic position and suicide risk.

Healthcare investment and income inequality

This paper examines how the relative shares of public and private health expenditures impact income inequality. We study a two period overlapping generation's growth model in which longevity is determined by both private and public health expenditure and human capital is the engine of growth. Increased investment in health, reduces mortality, raises return to education and affects income inequality. In such a framework we show that the cross-section earnings inequality is non-decreasing in the private share of health expenditure.We test this prediction empirically using a variable that proxies for the relative intensity of investments (private versus public) using vaccination data from the National Sample Survey Organization for 76 regions in India in the year 1986–87. We link this with region-specific expenditure inequality data for the period 1987–2012. Our empirical findings, though focused on a specific health investment (vaccines), suggest that an increase in the share of the privately provided health care results in higher inequality.     

The socioeconomic impact of a femoral neck fracture on patients aged 18-50: A population-based study

BackgroundBy linking health and census data, the objective of this study was to determine the effect of a femoral neck fracture on the household income of non-elderly patients.MethodsAll individuals aged 18–50 who underwent internal fixation for a femoral neck fracture during the years 2006–2012 in the Canadian Province of British Columbia were included in the study. Patient-level hospital data was linked with patient’s after-tax household income decile, as estimated by Statistics Canada Postal Code Conversion Files. The primary endpoint was a decline of ≥2 income deciles following the index fracture. Kaplan-Meier analysis was performed to estimate the probability of income decline during the study period. A Cox regression model was used to study the association between a ≥2 income decline and patient age, sex, reoperation, and pre-injury income decile.ResultsOf the 391 femoral neck fracture patients included, the majority of patients were male (61.6%), with a median age of 43 years (IQR: 35–48), and a pre-injury median income in the fifth decile (IQR: decile 3–8). 27.0% of patients sustained a decline of ≥2 income deciles during the study period, with 16.3% declining ≥2 income deciles within 2-years of injury. A pre-injury household income in the top 4 deciles (mean of deciles: $57,000–170,500) was associated with an increased likelihood of a ≥2 drop in household income (HR: 1.38, 95% CI: 1.06–1.79, p = 0.02).DiscussionOver a quarter of the femoral neck fracture patients in this study sustained a decline of ≥2 deciles in their household income following their injury. The income decline was disproportionately absorbed by patients with baseline incomes in the 6^th decile or higher. This suggests that the available incapacity programs are limited in providing income protection to patients with higher incomes.     

云南省个旧市急性腹泻的影响因素分析

摘要:目的　了解个旧市急性腹泻的影响因素,为科学制定防制措施提供依据和支持。方法　采用病例-对照研究的方法,自行设计量表收集个旧市8家医疗机构一年内的初诊急性腹泻病例和同样数量的医院内对照的基本情况、暴露史、卫生习惯等信息。数据采用单因素卡方和多因素Logistic 回归进行分析。结果　个旧市急性腹泻的主要临床表现,如大便性状、腹痛、呕吐、发热等,提示以感染性腹泻为主。多因素Logistic回归分析显示,家庭人均年收入（OR＝0.819,P＝0.001）、饭前便后洗手（OR＝0.572,P＝0.001）、经常与别人共用餐具（OR＝2.163,P＝0.010）、经常外出就餐（OR＝2.471,P＝0.008）、发病3 d内外出就餐（OR＝2.566,P＝0.006）和接触腹泻患者（OR＝1.152,P＝0.039）为急性腹泻感染的影响因素。结论　个旧市急性腹泻以夏季高发;影响因素有家庭人均年收入、饭前便后洗手习惯、经常与别人共用餐具、经常外出就餐、发病3 d内外出就餐和接触腹泻患者等,防制措施包括开展居民卫生习惯的健康教育、帮助低收入家庭改善卫生条件、加强餐饮行业的食品安全监管等。     

玉环县4367例已婚妇女常见病普查及分析

目的了解本地区已婚妇女常见病的发病情况,促进妇女生殖健康水平。方法对本地区已婚妇女普查,观察发病情况及与年龄、文化水平、经济水平的关系。结果 4367例已婚妇女中检出常见病2401例,发病率为54.98%;以宫颈疾病和阴道疾病为主,分别检出957例和879例,发病率分别为21.91%和20.13%;患病率最高的两个年龄段为30～39岁及20～29岁,发病率分别为67.47%和59.43%,40岁以上患病率随年龄增长呈下降趋势;小学及以下文化水平妇女患病率最高,为66.14%,初中、高中以上文化水平患病率分别为54.03%和44.32%;家庭月收入〈2000元的已婚妇女发病率最高,为69.81%,家庭收入在2000～4999元的患病率为55.35%,家庭收入≥5000元的妇女患病率最低,为40.91%。结论玉环县地区妇女健康状况不容乐观,应重视弱势人群的健康状况,加强健康教育,定期对妇女进行妇科病普查,有利于早发现、早诊断、早治疗。     

Does income inequality modify the association between air pollution and health?

BACKGROUND: It has been hypothesized that socioeconomic status may act as an effect modifier of the association between air pollution and health. In this study, we investigated whether income inequality may modify the association between fine particulate pollution and self-reported health. METHODS: We combined several different sources of data. Demographic and socio-economic data, at the individual level, were drawn from the 2001 US Behavioral Risk Factor Surveillance System (BRFSS). County-level particulate pollution data for the year 2001 were provided by the US Environmental Protection Agency. State-level income inequality was measured by the Gini index using US census data from the year 2000. We used a hierarchical logistic regression to model the association between general self-reported health and fine particulate pollution accounting for income inequality as an effect modifier and controlling for the usual confounders. RESULTS: We found that when income inequality is low (10th percentile of the Gini distribution), the odds of reporting fair or poor health for a 10microg/m3 increase in particulate pollution is 1.34 (95% confidence interval 1.21-1.48). The analogous odds ratio for higher income inequality (60th percentile of the Gini distribution) is 1.11 (95% confidence interval 1.06-1.16). CONCLUSIONS: Income inequality was found to be an effect modifier of the association between general self-reported health and particulate pollution. However, these findings challenged our hypothesis that people living in higher income inequality areas are more vulnerable to the impact of air pollution. We discuss the factors driving these results.     

Income inequality and limitations in activities of daily living: a multilevel analysis of the 2003 American Community Survey

OBJECTIVES: This study examined whether state income inequality was associated with an individual's limitations in activities of daily living (ADL) when controlling for the individual's demographic and socio-economic characteristics. STUDY DESIGN AND METHODS: The study was based on secondary analyses of data collected in the 2003 American Community Survey (ACS). The ACS is a national survey of Americans with a 96.7% response rate. The sample used for this research included 645,835 participants aged 25 years and older. A multilevel model with a non-linear logit link function was used. RESULTS: A 0.05 increase in the Gini coefficient (a measure of state level income inequality) was associated with an increase of 11% in the odds of ADL limitations [odds ratio (OR) 1.11, 95% confidence intervals 1.01-1.22] even after controlling for the individual's demographic and socio-economic characteristics. These elevated odds are comparable with those associated with women in comparison with men (OR 1.12). A separate analysis indicated that individuals in the three least equitable states had consistently higher probabilities of ADL limitations across the whole economic spectrum when compared with individuals in the three most equitable states. CONCLUSIONS: State-level income inequality and individual income levels were significant independent predictors of ADL limitations. The impact of any future changes in state-level income inequality or shifts in individual income levels in the USA could be used to further investigate if this relationship is causal.     

膳食和环境因素与我国城乡居民超重、肥胖关系的研究

目的探讨我国成年人体质指数(BMI)与膳食和环境因素之间的关系。方法利用"中国居民健康与营养调查"资料,18~60岁参加2000年调查并且2004年调查被随访到者3284人作为研究对象,考察BMI的变化情况以及BMI与膳食和环境因素之间的关系。结果2000年平均BMI为22.8 kg/m2,2004年为23.2kg/m2,同期超重和肥胖的比例(BMI24 kg/m2)从31.6%增加到36.5%。4年间总能量摄入量减少,但脂肪供能增加;与农村居民相比,城市居民消费的脂肪更多、BMI更高;高家庭收入与高脂肪摄入量和高BMI有关联;高脂肪、高能量摄入量与高BMI有关联,男性更明显;高体力活动水平与低BMI有关联。结论明确膳食和环境因素与人群BMI之间的关联对控制人群的超重和肥胖有着重要的指导意义。