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Background Traumatic brain injury (TBI) is disproportionately prevalent among individuals who intersect or are involved with the criminal justice system (CJS). In the absence of appropriate care, TBI-related impairments, intersecting social determinants of health, and the lack of TBI awareness in CJS settings can lead to lengthened sentences, serious disciplinary charges, and recidivism. However, evidence suggests that most clinical practice guidelines (CPGs) overlook equity and consequently, the needs of disadvantaged groups. As such, this review addressed the research question 'To what extent are (1) intersections with the CJS considered in CPGs for TBI, (2) TBI considered in CPGs for CJS, and (3) equity considered in CPGs for CJS?'. Methods and findings CPGs were identified from electronic databases (MEDLINE, Embase, CINAHL, PsycINFO), targeted websites, Google Search, and reference lists of identified CPGs on November 2021 and March 2023 (CPGs for TBI) and May 2022 and March 2023 (CPGs for CJS). Only CPGs for TBI or CPGs for CJS were included. We calculated the proportion of CPGs that included TBI- or CJS-specific content, conducted a qualitative content analysis to understand how evidence regarding TBI and the CJS was integrated in the CPGs, and utilised equity assessment tools to understand if and how equity was considered. Fifty-seven CPGs for TBI and 6 CPGs for CJS were included in this review. Fourteen CPGs for TBI included information relevant to the CJS, but only 1 made a concrete recommendation to consider legal implications during vocational evaluation in the forensic context. Two CPGs for CJS acknowledged the prevalence of TBI among individuals in prison and one specifically recommended considering TBI during health assessments. Both CPGs for TBI and CPGs for CJS provided evidence specific to a single facet of the CJS, predominantly in policing and corrections. The use of equity best practices and the involvement of disadvantaged groups in the development process were lacking among CPGs for CJS. We acknowledge limitations of the review, including that our searches were conducted in English language and thus, we may have missed other non-English language CPGs in this review. We further recognise that we are unable to comment on evidence that is not integrated in the CPGs, as we did not systematically search for research on individuals with TBI who intersect with the CJS, outside of CPGs. Conclusions Findings from this review provide the foundation to consider CJS involvement in CPGs for TBI and to advance equity in CPGs for CJS. Conducting research, including investigating the process of screening for TBI with individuals who intersect with all facets of the CJS, and utilizing equity assessment tools in guideline development are critical steps to enhance equity in healthcare for this disadvantaged group., Author(s): Zoe Colclough 1, Maria Jennifer Estrella 2, Julie Michele Joyce 2, Sara Hanafy 3,4, Jessica Babineau 5,6, Angela Colantonio 2,3,4,7,8, Vincy Chan 3,4,7,* Introduction Traumatic brain injury (TBI) affects [...]

The overall purpose of the paper is to analyze the free supply of menstrual items to primary and secondary school girls in New Zealand using the substantive equality principle. The New Zealand government's incentive for free supply of the articles to menstruating girls was their worrying absenteeism at school due to menstrual poverty. Menstrual poverty limits school girls' equal access to their fundamental right to education. In my analysis, I adopt a human rights approach, employing the substantive equality principle to reflect on this rationale to provide menstrual products to school girls who need them. My research cites scholarly texts, organizational and media works from multidisciplinary literature to support the free supply of sanitary products. Using this research, I demonstrate that the supply satisfies the multiple interpretations of substantive equality for the attainment of menstruating girls' equal access to their right to education. The government program addresses menstrual poverty and facilitates the management of menstruation with dignity. Keywords: Menstrual poverty, School girls, Substantive equality, Right to education, New Zealand, Introduction Across most cultures and political settings, menstrual or sanitary articles are still a taboo subject (2) of secrecy. In other words, there is a menstrual taboo. Almost fifty percent [...]

Context: Before availability of COVID-19 vaccinations, rural counties with majority racial and ethnic minority populations were disproportionately impacted by COVID-19 compared to majority Non-Hispanic White (NHW) counties. Objective: Describe disparities in COVID-19 outcomes across majority NHW and minority NHW rural counties before and after the widespread availability of COVID-19 vaccinations. Study Design: Rural counties were categorized as, Presenters Anne Gaglioti, MD, FAAFP, MS, Robina Josiah Willock, PhD, MPH, Megan Douglas, JD, Lee Caplan, MD, PhD, MPH, Ashley Daniel, BS, MS, Peter Baltrus, PhD, Dominic Mack, MD, MBA, [...]

Background/Objectives This study determined time trends in the prevalence of malnutrition and its socioeconomic inequality among children under five at a national level and by urbanity in Thailand. Subjects/Methods This study compared malnutrition prevalence and inequality among children under five by wealth index score and urbanity using three Multiple Indicator Cluster Surveys for 2005-06, 2012, and 2015-16. The magnitude of inequality was measured on absolute (slope index of inequality) and relative scales (relative index of inequality). Results National prevalence of stunting decreased substantially (16% in 2005-06 and 2012 and 10% in 2015-16), whereas overweight prevalence did not meaningfully change. Inequalities in stunting and overweight by wealth decreased over time nationally on both absolute and relative scales (p-trend < 0.001). Similar decreasing patterns in inequalities were seen in both rural and urban areas, though substantial inequalities persisted. Poor children remained stunted (11.6% in the rural poor and 14.8% in the urban poor), wasted (6.6% in the rural poor), and, strikingly, also overweight (from 5.5% in 2005-06 to 9% in 2015-16 for the rural poor and 8% over time for the urban poor). Conclusion Despite favorable time trends in socioeconomic inequality, this study showed the existence of a double burden of malnutrition (under-nutrition and overweight) in young Thai children with persistent inequalities at the national level. Different patterns of this double burden were seen between urban and rural areas. Public health policies should target both under-nutrition and overweight and consider urbanity in this rapidly developing society., Author(s): Seo Ah Hong [sup.1] [sup.2] , Pattanee Winichagoon [sup.3] , Young-Ho Khang [sup.4] Author Affiliations: (1) ASEAN Institute for Health Development, Mahidol University, Phutthamonthon District, Thailand (2) Institute for [...]

A growing body of research emphasises the role of 'social determinants of health' in generating inequalities in health outcomes. How, if at all, should primary care providers respond? In this paper, I want to shed light on this issue by focusing on the role that 'big data' might play in allowing primary care providers to respond to the social determinants that affect individual patients' health. The general idea has been proposed and endorsed by the Institute of Medicine, and the idea has been developed in more detail by Bazemore et al. (2016 (See CR3)). In Bazemore et al.'s proposal, patients' addresses are used to generate information about the patients' neighbourhood; this information is then included in patients' health care records and made available to providers. This allows primary care providers to take this information into account when interacting with, and providing care to, patients. I explore three issues arising from this proposal. First, while questions of privacy have been central to discussions about big data, Bazemore et al.'s proposal also allows us to see that there might be costs to not making certain information available. Second, I consider some of the questions arising for primary care from the influence of social factors on health outcomes: given that we know these factors to be significant contributors to social inequalities in health, what precisely should be done about this in the primary care context? Finally, I address problems arising from the use of population level data when dealing with individuals., Author(s): Kristin Voigt [sup.1] Author Affiliations: (Aff1) 0000 0004 1936 8649, grid.14709.3b, Institute for Health and Social Policy & Department of Philosophy, McGill University, , 1130 Pine Ave W, H3A [...]

Never in our lifetime has it been so evident that leaders in health and human services must be 'navigators in hope'--charting a course for the future through the global COVID-19 [...]

Background We aimed to estimate multimorbidity trajectories and quantify socioeconomic inequalities based on childhood and adulthood socioeconomic position (SEP) in the risks and rates of multimorbidity accumulation across adulthood. Methods and findings Participants from the UK 1946 National Survey of Health and Development (NSHD) birth cohort study who attended the age 36 years assessment in 1982 and any one of the follow-up assessments at ages 43, 53, 63, and 69 years (N = 3,723, 51% males). Information on 18 health conditions was based on a combination of self-report, biomarkers, health records, and prescribed medications. We estimated multimorbidity trajectories and delineated socioeconomic inequalities (based on childhood and adulthood social class and highest education) in multimorbidity at each age and in longitudinal trajectories. Multimorbidity increased with age (0.7 conditions at 36 years to 3.7 at 69 years). Multimorbidity accumulation was nonlinear, accelerating with age at the rate of 0.08 conditions/year (95% CI 0.07 to 0.09, p < 0.001) at 36 to 43 years to 0.19 conditions/year (95% CI 0.18 to 0.20, p < 0.001) at 63 to 69 years. At all ages, the most socioeconomically disadvantaged had 1.2 to 1.4 times greater number of conditions on average compared to the most advantaged. The most disadvantaged by each socioeconomic indicator experienced an additional 0.39 conditions (childhood social class), 0.83 (adult social class), and 1.08 conditions (adult education) at age 69 years, independent of all other socioeconomic indicators. Adverse adulthood SEP was associated with more rapid accumulation of multimorbidity, resulting in 0.49 excess conditions in partly/unskilled compared to professional/intermediate individuals between 63 and 69 years. Disadvantaged childhood social class, independently of adulthood SEP, was associated with accelerated multimorbidity trajectories from age 53 years onwards. Study limitations include that the NSHD cohort is composed of individuals of white European heritage only, and findings may not be generalizable to the non-white British population of the same generation and did not account for other important dimensions of SEP such as income and wealth. Conclusions In this study, we found that socioeconomically disadvantaged individuals have earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood SEP., Author(s): Amal R. Khanolkar 1,2, Nishi Chaturvedi 1, Valerie Kuan 3, Daniel Davis 1, Alun Hughes 1, Marcus Richards 1, David Bann 4, Praveetha Patalay 1,4,* Introduction The management of [...]

Recent research shows increasing inequality in mortality among middle-aged and older adults. But this is only part of the story. Inequality in mortality among young people has fallen dramatically in the United States converging to almost Canadian rates. Increases in public health insurance for U.S. children, beginning in the late 1980s, are likely to have contributed. (JEL D63, 118, 138, J1, J3, J18), I. INTRODUCTION Orley Ashenfelter. It is my great pleasure to introduce Janet Currie today. My name is Orley Ashenfelter, President-Elect of the Western Economic Association International (WEAI). I do not [...]

The debate on human categorization based on 'race,' its relationship to genetic variation among populations, and its scientific legitimacy has been raging for decades. Yet, there is still no clear [...]

Author(s): Maya L. Nadimpalli [sup.1] [sup.2] , Courtney W. Chan [sup.3] , Shira Doron [sup.2] [sup.3] Author Affiliations: (1) Department of Civil and Environmental Engineering, Tufts University, Medford, USA (2) [...]

An NBER conference on Inequalities in Mortality in the US and Beyond took place March 4 online. Research Associate Janet Currie of Princeton University and Faculty Research Fellow Hannes Schwandt [...]

Inequalities in health persist worldwide and one of the starting points for remedial action is collecting data that reveal patterns of inequality. Current discussions about the best ways of monitoring [...]

Objective To assess international shortfall inequality in life expectancy at birth among women and men and the influence of geography and country income group. Methods The authors used estimates of life expectancy at birth, by sex, for 12 five-year periods between 1950-1955 and 2005-2010 and estimates of population for the midpoints of each period from the World population prospects, 2008 revision. Shortfall inequality was defined as the weighted average of the deviations of each country's average life expectancy by sex from the highest attained life expectancy by sex for each period. Findings International shortfall inequalities in life expectancy among men and among women decreased between 1950 and 1975 but stagnated thereafter. International shortfall inequality in life expectancy has been higher in women than in men, ranging from 1.9 to 2.9 years. Women in low-income countries have the biggest shortfall, currently at around 26.7 years. Conclusion International shortfall inequality is higher among women than men primarily because women in low-income and lower-middle-income country groups show larger differences in life expectancy than men. Further investigation is needed to determine the pathways causing these inequalities. Objectif Evaluer l'inegalite internationale de l'esperance de vie a la naissance des femmes et des hommes, en termes decart, et l'influence de la geographie et de l'appartenance a un groupe de pays avec un certain revenu. Methodes Les auteurs ont utilise les estimations de l'esperance de vie a la naissance, par sexe, pour les 12 periodes de 5 ans entre 1950-1955 et 2005-2010, ainsi que les estimations de la population au milieu de chaque periode des Perspectives demogrophiques mondiales, revision de 2008. L'inegalite mesuree en termes d'ecart a ete definie comme la moyenne ponderee des ecarts entre l'esperance de vie moyenne de chaque pays par sexe, par rapport a l'esperance de vie la plus elevee atteinte par sexe sur chaque periode. Resultats Les inegalites internationales de l'esperance de vie entre les hommes et entre les femmes, mesuree en termes d'ecart, a diminue entre 1950 et 1975, mais a ensuite stagne. L'inegalite internationale de l'esperance de vie, mesuree en termes d'ecart, est plus elevee chez les femmes que chez les hommes, allant de 1,9 a 2,9 annees. Le plus grand ecart concerne les femmes des pays a revenu faible, actuellement d'environ 26,7 annees. Conclusion L'inegalite internationale, mesuree en termes d'ecart, est plus elevee entre les femmes qu'entre les hommes, principalement parce que les femmes des groupes de pays a revenu faible et revenu intermediaire de trancheinferieure montrent des differences d'esperance de vie plus importantes que les hommes. Une etude plus approfondie est necessaire pour determiner les causes de ces inegalites. Objetivo Evaluar la desigualdad internacional en la desviacion en la esperanza de vida en el nacimiento entre mujeres y hombres y la influencia de la geografia y del grupo de ingresos del pais. Metodos Los autores emplearon estimaciones de esperanza de vida en el nacimiento, por sexo, para 12 periodos de cinco anos entre 1950-1955 y 2005-2010 y las estimaciones de poblacion para los puntos medios de cada periodo a traves de World population prospects, 2008 revision. La desigualdad en la desviacion se definio como el promedio ponderado de las desviaciones de la esperanza de vida de cada pais por sexo partiendo de la mayor esperanza de vida alcanzada por sexo para cada periodo. Resultados Las desigualdades internacionales en las desviaciones en la esperanza de vida entre hombres y mujeres descendieron entre 1950 y 1975 pero se estancaron a partir de entonces. La desigualdad internacional en la desviacion en la esperanza de vida ha sido superior en las mujeres que en los hombres, oscilando entre 1,9 y 2,9 anos. Las mujeres de paises de ingresos bajos sufren la mayor desigualdad, actualmente en torno a 26,7 anos. Conclusion La desigualdad internacional en la desviacion es mayor entre las mujeres que entre los hombres principalmente porque las mujeres de grupos de paises de ingresos bajos y bajos-medios registran mayores diferencias en la esperanza de vida que los hombres. Es necesario investigar este tema mas en profundidad para determinar los mecanismos causantes de estas desigualdades., Introduction Life expectancy at birth has long been recognized as a summary measure of mortality that allows inequality levels and trends to be compared within and across societies. (1) The [...]

When President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on 23 March 2010, it was a momentous achievement for medically underserved communities. Although the [...]

Summary Uptake of cancer screening by people with learning disabilities in England is poor. Data were collected using a short online questionnaire to estimate awareness of cancer screening programmes among [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2009.10.019 Byline: David Granlund (a), Nguyen T. Chuc (b), Ho D. Phuc (c), Lars Lindholm (d) Abstract: Vietnam has experienced rapid economic growth following the transition, which began in the mid 1980s, from a planned agriculture based economy to a more market orientated one. In this paper, the associations between socioeconomic variables and mortality for 41,000 adults in Northern Vietnam followed from January 1999 to March 2008 are estimated using Cox's proportionally hazard models. Also, we use decomposition techniques to investigate the relative importance of socioeconomic factors for explaining inequality in age-standardized mortality risk. The results confirm previously found negative associations between mortality and income and education, for both men and women. We also found that marital status, at least for men, explain a large and growing part of the inequality. Finally, estimation results for relative education variables suggest that there exist positive spillover effects of education, meaning that higher education of one's neighbors or spouse might reduce ones mortality risk. Author Affiliation: (a) The Swedish Retail Institute (HUI) and UmeA[yen] University, Department of Economics, Stockholm/UmeA[yen], Sweden (b) Faculty of Public Health, Hanoi Medical University, Viet Nam (c) Institute of Mathematics, Hanoi, Viet Nam (d) Department of Public Health and Clinical Medicine, UmeA[yen] University, Sweden

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2009.08.012 Byline: Gerard J. van den Berg, Maarten Lindeboom, Marta Lopez Abstract: We analyze the effect of being born in a recession on the mortality rate later in life in conjunction with social class. We use individual data records from Dutch registers of birth, marriage, and death certificates, covering the period 1815-2000, and we merge these with historical data on macro-economic outcomes and health indicators. We estimate duration models and inequality measures. The results indicate that being born in a recession increases the mortality rate later in life for most of the population. Lower social classes suffer disproportionally from being born in recessions. This exacerbates mortality inequality. Upward mobility does not vary much with the business cycle at birth. Author Affiliation: Vrije Universiteit Amsterdam, Amsterdam, Netherlands Article Note: (footnote) [star] We thank two anonymous referees, the Editors, and participants in seminars and conferences in Princeton, Tilburg, Tours, Barcelona, Amsterdam and Copenhagen, in particular Arie Kapteyn, Andrew Chesher, Anne Case, Angus Deaton, Eileen Crimmins, and Eddy van Doorslaer, for useful comments. The 'Historical Sample of the Netherlands Dataset release UZF.02' was kindly provided by the International Institute of Social History (IISG) in Amsterdam. Some results derived from datasets deposited at the NHDA, and we are grateful for Stichting DANS and Dirk Jan Noordam for permission to use them. Thanks to France Portrait for help with the preparation of the data. Part of this paper was written while the first author was at the Center for Health and Wellbeing at Princeton University.

Background. We investigated social inequalities in walking speed in early old age. Methods. Walking speed was measured by timed 8-ft (2.44 m) test in 6,345 individuals, with mean age of 61.1 (SD 6.0) years. Current or last known civil service employment grade defined socioeconomic position. Results. Mean walking speed was 1.36 (SD 0.29) m/s in men and 1.21 (SD 0.30) in women. Average age- and ethnicity-adjusted walking speed was approximately 13% higher in the highest employment grade compared with the lowest. Based on the relative index of inequality (RII), the difference in walking speed across the social hierarchy was 0.15 m/s (95% confidence interval [CI] 0.12-0.18) in men and 0.17 m/s (0.12-0.22) in women, corresponding to an age-related difference of 18.7 (13.6-23.8) years in men and 14.9 (9.9-19.9) years in women. The RII for slow walking speed (logistic model for lowest sex-specific quartile vs others) adjusted for age, sex. and ethnicity was 3.40 (2.64-4.36). Explanatory factors for the social gradient in walking speed included Short-Form 36 physical functioning, labor market status, financial insecurity, height, and body mass index. Demographic. psychosocial, behavioral, biologic, and health factors in combination accounted for 40% of social inequality in walking speed. Conclusion. Social inequality in walking speed is substantial in early old age and reflects many factors beyond the direct effects of physical health. Key Words: Socioeconomic position--Physical functioning--Epidemiology--Humans.