Search

Previous research indicates that the disproportionate distribution of income within society is associated with aggression and violence. Although research has been conducted identifying the relationship between income inequality and bullying victimization and perpetration, little is known about possible mediators. We investigated the association between income inequality and bullying perpetration and victimization among adolescents participating in the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behavior (COMPASS) study. We identified whether school connectedness and psychosocial well-being mediated the relationship between income inequality and bullying behavior. This study used pooled cross-sectional data from 147,748 adolescents aged 13 to 18 from three waves (2015-2016, 2016-2017, 2017-2018) of the COMPASS study from 157 secondary schools in British Columbia, Alberta, Ontario, and Quebec (Canada). The Gini coefficient was calculated based on the school Census Divisions (CD) using the Canada 2016 Census and linked with student data. We used multilevel modeling to investigate the relationship between income inequality and self-reported bullying victimization and perpetration, while controlling for individual-, school-, and CD-level characteristics. A standard deviation increase in Gini coefficient was associated with increased odds for bullying victimization and perpetration. Findings were observed among girls; however, inequality was only associated with perpetration among boys. We identified social cohesion and psychosocial well-being as potential mediators. To counter the adverse effects of income inequality, school-based interventions designed to increase school connectedness and student psychosocial well-being should be implemented to protect against bullying.

BACKGROUND: Income inequality is theorized to impact health. However, evidence among adolescents is limited. This study examined the association between income inequality and health‐related school absenteeism (HRSA) in adolescents. METHODS: Participants were adolescents (n = 74,501) attending secondary schools (n = 136) that participated in the 2018‐2019 wave of the COMPASS study. Chronic (missing ≥3 days of school in the previous 4 weeks) and problematic (missing ≥11 days of school in the previous 4 weeks) HRSA was self‐reported. Income inequality was assessed via the Gini coefficient at the census division (CD) level. Multilevel modeling was used. RESULTS: Greater income inequality was associated with a higher likelihood of chronic and problematic HRSA (chronic: OR = 1.17, 95% CI: 1.06, 1.30; problematic: OR = 1.29, 95% CI 1.11 to 1.50). Increased predicted probabilities for Problematic HRSA were observed at greater degrees of income inequality among students who identified as either white, black, Latinx, or mixed, while protective associations were observed among students who identified as Asian or other. No associations were modified by gender. CONCLUSION: Income inequality demonstrated unfavorable associations with HRSA, which was modified by racial identity. [ABSTRACT FROM AUTHOR]

We explored how investments in housing for vulnerable populations (including those experiencing homelessness) are described as leading to cost containment for the health, justice, and social service systems; the nature of any costs and benefits; and variations by housing type and over time. A structured search of peer-reviewed academic research focused on the core concepts of economic benefit, public housing programs, and vulnerable populations. Findings from 42 articles reporting on cost containment specific to health, justice, and social service systems at the municipal, regional, and/or state/provincial level were synthesized. Most of the studies focused on supportive housing interventions, targeted adults (mainly men) experiencing chronic homelessness in the USA, and reported results over 1–5 years. Approximately half of the articles reported on the costs required to house vulnerable populations. About half reported on funding sources, which is critical information for leadership decisions in cost containment for supportive housing. Most of the studies assessing program cost or cost-effectiveness reported a reduction in service costs and/or greater cost-effectiveness. Studies mostly reported impacts on health services, with hospital/inpatient care and emergency service use typically decreasing across the intervention types. All the studies that assessed cost impacts on the justice system reported a decrease in expenditures. Housing vulnerable populations was also found to decrease shelter service use and engagement with the foster care/welfare systems. Housing interventions may offer cost-savings in the short- and medium-term, with a limited evidence base also demonstrating long term benefit. [ABSTRACT FROM AUTHOR]

Our study examines the association between perceived discrimination due to race and unmet medical needs among a nationally representative sample of children in the United States. We used data from the 2016-2017 National Survey of Children's Health, a population-based cross-sectional survey of randomly selected parents or guardians in the United States. We compared results from the coarsened exact matching (CEM) method and survey-weighted logistic regression to assess the robustness of the results. Using self-reported measures from caregivers, we find that ∼2.7% of US children have experienced racial discrimination with prevalence varying significantly by race. While <1% of non-Hispanic whites have experienced some measure of racism, this increases to 8.8% among non-Hispanic blacks. Perceived discrimination was associated with significantly greater odds of unmet medical needs in the adjusted, survey-weighted multivariate-adjusted model (adjusted odds ratio [OR] = 2.4 and 95% confidence interval [CI] = 1.2, 4.9) as well as in the CEM-model estimate (OR = 2.8 and 95% CI = 1.8, 4.0). Children who have experienced perceived discrimination had higher odds of unmet medical needs. Awareness of discrimination among children may help inform future intervention development that addresses unmet medical needs during childhood. [ABSTRACT FROM AUTHOR]

Background: Several studies have linked neighbourhood environment to preschool-aged children's behavioural problems. Income inequality is an identified risk factor for mental health among adolescents, however, little is known as to whether this relationship extends to younger children. Objective: To explore the association between neighbourhood-level income inequality and general psychopathology problems among preschool-aged children. Methods: We analyzed data from the All Our Families (AOF) longitudinal cohort located in Calgary, Canada at 3-years postpartum. The analytical sample consisted of 1615 mother-preschooler dyads nested within 184 neighbourhoods. Mothers completed the National Longitudinal Survey of Children and Youth Child Behaviour Checklist (NLSCY-CBCL), which assessed internalizing and externalizing symptoms. Income inequality was assessed via the Gini coefficient, which quantifies the unequal distribution of income in society. Mixed effects linear regression assessed the relationship between neighbourhood income inequality and preschooler's general psychopathology. Results: The mean Gini coefficient across the 184 neighbourhoods was 0.33 (SD = 0.05; min, max: 0.20-0.56). In the fully adjusted model income inequality was not associated with general psychopathology in children β = 0.07 (95%CI: -0.29, 0.45). Neighbourhood environment accounted for 0.5% of the variance in psychopathology in children. Conclusion: The lack of significant findings may be due to a lack of statistical power in the study. Future studies should investigate this relationship with appropriately powered studies, and over time, to assess if income inequality is a determinant of preschooler psychopathology in Canada. [ABSTRACT FROM AUTHOR]

Purpose: Our objective was to estimate inequities in heavy drinking between heterosexual, gay or lesbian, and bisexual or pansexual individuals, by sex/gender, and to determine whether this association is heterogeneous across racially minoritized status and income groups in Canadians aged 15 and older. Methods: We pooled three Canadian Community Health Survey cycles (2015-2020) and used separate modified Poisson regressions to explore the sex/gender-specific association between sexual identity and heavy drinking prevalence by racially minoritized status, and income, adjusted for survey cycle, age, marital status, and region. Results: With racially minoritized status, and income categories collapsed, heavy drinking was 1.3 times higher (95% confidence interval [CI] = 1.0-1.7) among bisexual or pansexual women compared with heterosexual women, with no differences among men. Among racially minoritized women, heavy drinking was 2.9 (95% CI = 1.3-6.4) times higher among bisexual or pansexual women and 1.9 (95% CI = 0.7-5.2) times higher among gay or lesbian women compared with heterosexual women. Among racially minoritized men, heavy drinking was 1.9 (95% CI = 0.9-4.0) times higher among gay men compared with heterosexual men. No differences were observed across sexual identity in White men or women. Bisexual or pansexual women reported increased heavy drinking relative to heterosexual women across income quintiles. Conclusion: Heavy drinking is distributed heterogeneously across sexual identity, sex/gender, racially minoritized status, and income. These results encourage equity-focused interventions to reduce heavy drinking among intersecting sociodemographic groups experiencing a greater burden of heavy drinking.

Background: Rates of drug overdoses, alcohol-related liver disease and suicide attempts represent a major public health burden in Canada. While the existing literature does highlight some evidence of association between income inequality and mental health and deaths of despair, no existing research has investigated more intermediate events. As such, the objective of the current study is to investigate the association between income inequality and hospitalisations of despair over time., Methods: Data from the 2006 Canadian Census, the 2007/2008 Canadian Community Health Survey and the 2007-2018 Discharge Abstract Database were linked. Data were analysed using Cox proportional hazards modelling accounting for robust standard errors at the area level to investigate associations between income inequality at baseline and hazards for hospitalisations of despair, hospitalisations attributable to drug overdose, alcohol-related liver disease and suicide attempts, and all-cause hospitalisations, while controlling for sociodemographics characteristics (including income) and relevant area-level variables., Results: The results highlighted statistically significant associations between income inequality and hazard of hospitalisations of despair (HR 1.38, 95% CI 1.06 to 1.80), hospitalisations related to drug overdose (HR 1.51, 95% CI 1.07 to 2.13) and all-cause hospitalisations (HR 1.17, 95% CI 1.05 to 1.30). The association between income inequality and hospitalisations related to alcohol-related liver disease and suicide attempts/self-harm were not statistically significant., Conclusion: Overall, the results showed evidence of associations between income inequality and hospitalisations of despair, drug overdose-related hospitalisations and all-cause hospitalisations. These findings are applicable to upstream policy discussion regarding reducing income inequality and identify potential points of intervention for prevention of drug overdose, alcohol-related liver disease and suicide attempts/self-harm., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: In the United States, Hispanics are more likely to experience financial barriers to mental health care than non-Hispanics. We used a unique survey to study the effect of these financial barriers on the severity of depressive symptoms among Hispanics who had previously been diagnosed as having depression. Methods: This cross-sectional study used data from the 2015 Washington Heights Community Survey, administered to 2,489 households in Manhattan, New York City. Multiple regression models and propensity score matching were used to estimate the association between financial barriers to mental health care and depressive symptoms and the likelihood of being clinically depressed. Results: Among those diagnosed with depression, those with financial barriers to mental health services or counseling had significantly higher (β = 0.36, 95% CI = 0.03, 0.70) depressive symptoms. When propensity score matching was utilized, those with financial barriers to mental health services had significantly greater depressive symptoms (β = 0.63, 95% CI = 0.37, 0.89) and were significantly more likely to be currently depressed (OR = 2.38, 95% CI = 1.46, 3.89), in comparison to those who had access. Conclusions: Making mental health care more affordable and therefore more accessible to Hispanics is one step toward mitigating the burden on mental illness and decreasing health disparities.

Background: Nearly one-third of secondary school students report experiencing depressive symptoms in the past year. Existing research suggests that increasing rates of depression are due in part to increasing income inequality. The aim of this study is to identify mechanisms by which income inequality contributes to depression among Canadian secondary school students., Methods: We used data from a large sample of Canadian secondary school students that participated in the 2017/18 wave of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) study. The sample included 61,642 students across 43 Census divisions (CDs) in Quebec, Ontario, Alberta, and British Columbia. We used multilevel path analysis to determine if the relationship between CD-level income inequality and depression was mediated by student's psychosocial well-being and/or social cohesion., Results: Attending schools in CDs with higher income inequality was related to higher depression scores among Canadian secondary students [unstandardized ß ( ß ) = 5.36; 95% CI = 0.74, 9.99] and lower psychosocial well-being ( ß  = -14.83, 95% CI = -25.05, -4.60). Income inequality was not significantly associated with social cohesion, although social cohesion was associated with depression scores among students ( ß  = -0.31; 95% CI = -0.34, -0.28)., Discussion: Findings from this study indicate that income inequality is associated with adolescent depression and that this relationship is mediated by psychosocial well-being. This study is the first of its kind in Canada to assess the mechanisms by which income inequality contributes to adolescent depression. These findings are applicable to school-level programs addressing mental health., Competing Interests: None declared., (© 2021 The Authors.)