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Advances in the Health Effects of Place and Social Inequality

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 11928

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Special Issue Editor

Dr. Hossein Zare

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Guest Editor

Johns Hopkins Bloomberg School of Public Health, University of Maryland Global Campus, Largo, MD 20774, USA
Interests: income inequality; disparities; justice inequality; place-based inequality; geographical inequality
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Income inequality has sharply increased in recent years. Statistics show that the top one percent of the population captures a much larger share of total income growth. In the US in the last four decades, the actual annual earnings for the top 1% and bottom 90% increased by 158% and 24%, respectively, with wider gaps between men and women. Similar trends have been observed in other countries. The alarming trends in income inequality raise questions: What is happing if income inequality stays high? Does it harm all communities or only poor people, and who will suffer more?

Race and place are two other predictors of high income inequality and worse health outcome. Almost all socioeconomic factors, including income, are influenced by race and ethnicity. The National Academies of Sciences, Engineering, and Medicine has reported that African Americans and the poor consistently exhibit higher rates of multiple diseases, physical and mental impairment, functional limitations, and disabilities.

The neighborhood may be as important as income inequality and race/ethnicity. Neighborhoods with unique characteristics such as socioeconomic and geographical distribution impact how communities respond to extreme events. The degree to which neighborhoods experience social conditions, including high poverty, low educational attainment, or racial/ethnic minority status, often presents in combination. The literature suggests that race, neighborhood, and economic inequalities are predictors of low health outcomes.

The combination of income inequality, the racial composition of the population, and highly deprived neighborhoods creates areas with vulnerable populations. These areas have a higher proportion of lower-income, minority-group residents with poor health. In this Special Issue we want to learn how income inequality, race, and place drive health outcomes in communities.

Dr. Hossein Zare
Guest Editor

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

income inequality
racial disparities
place
neighborhood
health outcome (obesity, depression, diabetes, stoke, hypertension)
poverty
vulnerable populations

Published Papers (6 papers)

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Research

12 pages, 680 KiB

Open AccessArticle

Neighborhood Social Environment and Body Mass Index: The Mediating Role of Mental Wellbeing

by Shayna D. Cunningham, Jennifer Mandelbaum, Fatma M. Shebl, Mark Abraham and Kathleen O’Connor Duffany

Int. J. Environ. Res. Public Health 2023, 20(16), 6602; https://doi.org/10.3390/ijerph20166602 - 18 Aug 2023

Viewed by 1644

Abstract

The association between neighborhood-built environment and body mass index (BMI) is well-characterized, whereas fewer studies have explored the mechanisms underlying the relationship between neighborhood social environment and obesogenic behaviors. Using data from a random sample of 16,820 residents ≥18 years from all 169 Connecticut towns and seven ZIP Codes in New York, this study examines the influence of neighborhood social environment on residents’ mental wellbeing, physical activity, and BMI. Structural equation modeling was conducted to estimate direct and indirect effects of neighborhood social environment on BMI, using mental wellbeing and physical activity as intermediate variables. There were significant total [β(SE) = 0.741 (0.170), p < 0.0001], direct [β(SE) = 0.456 (0.1890), p = 0.016], and indirect [β(SE) = 0.285 (0.061), p < 0.0001] effects of neighborhood social environment on BMI. Low physical activity was a partial mediator of the effect of non-favorable neighborhood social environment on BMI [β(SE) = −0.071 (0.011), p < 0.0001]. The association between neighborhood social environment and BMI was also mediated by mental wellbeing [β(SE) = 0.214 (0.060), p < 0.0001], and by mental wellbeing through physical activity [β(SE) = 0.071 (0.011), p < 0.0001]. Study findings provide further support for building strong social environments to improve population health and suggest that strategies prioritizing mental wellbeing may benefit behavioral interventions aimed at reducing obesity risk and should be a focus of prevention efforts in and of itself. Full article

(This article belongs to the Special Issue Advances in the Health Effects of Place and Social Inequality)

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13 pages, 346 KiB

Open AccessArticle

Intergenerational Transmission of Obesity: Role of Education and Income

by Zhiwei Dong, Liping Wu, Yang Chen, Oleksii Lyulyov and Tetyana Pimonenko

Int. J. Environ. Res. Public Health 2022, 19(23), 15931; https://doi.org/10.3390/ijerph192315931 - 29 Nov 2022

Cited by 14 | Viewed by 1308

Abstract

Based on the sixth round of the 2018 Chinese Household Income Project family income survey (CHIP) data, this study made use of the OLS estimation and transfer matrix method to measure and test the problem of obesity intergenerational transmission, analyze whether there is obesity intergenerational transmission as well as between urban and rural areas, gender, and the parental education level and income level on the suppression of the obesity intergenerational transmission effect. The empirical results draw the following main conclusions: obesity intergenerational transmission in Chinese families, the degree of parental obesity has a significant positive impact on the degree of offspring obesity; the higher the degree of parental obesity, the more it can promote the degree of obesity in the offspring. Moreover, the degree of obesity intergenerational transmission is heterogeneous in urban and rural areas and gender. At the same time, the degree of rural obesity intergenerational transmission is higher than that of urban areas, and the degree of male obesity intergenerational transmission is higher than that of women. Full article

(This article belongs to the Special Issue Advances in the Health Effects of Place and Social Inequality)

12 pages, 359 KiB

Open AccessArticle

Pandemic Meets Endemic: The Role of Social Inequalities and Failing Public Health Policies as Drivers of Disparities in COVID-19 Mortality among White, Black, and Hispanic Communities in the United States of America

by Lorraine Frisina Doetter, Pasquale G. Frisina and Benedikt Preuß

Int. J. Environ. Res. Public Health 2022, 19(22), 14961; https://doi.org/10.3390/ijerph192214961 - 14 Nov 2022

Cited by 3 | Viewed by 1240

Abstract

The COVID-19 pandemic placed the United States of America (U.S.) under enormous strain, leaving it with higher deaths during the first wave of the outbreak compared to all other advanced economies. Blacks and Hispanics were among those hardest hit by the virus—a fact attributed to enduring problems related to the social determinants of health adversely affecting Communities of Color (CoC). In this study, we ask which distinct factors relating to policy stringency and community vulnerability influenced COVID-19 mortality among Whites, Blacks, and Hispanics during the first year of the pandemic. To address this question, we utilized a mix of correlational and regression analyses. Findings point to the highly divergent impact of public policy and vulnerability on COVID-19 mortality. Specifically, we observed that state-led measures aimed at controlling the spread of the virus only improved mortality for Whites. However, pre-existing social determinants of health (i.e., population density, epidemiological and healthcare system factors) played a significant role in determining COVID-19 outcomes for CoC, even in the face of stringent containment measures by states. This suggests that state-led policy to address present and/or future public health crises need to account for the particular nature of vulnerability affecting Blacks and Hispanics in the U.S. Full article

(This article belongs to the Special Issue Advances in the Health Effects of Place and Social Inequality)

18 pages, 2004 KiB

Open AccessArticle

District-Level Inequalities in Hypertension among Adults in Indonesia: A Cross-Sectional Analysis by Sex and Age Group

by Puput Oktamianti, Dian Kusuma, Vilda Amir, Dwi Hapsari Tjandrarini and Astridya Paramita

Int. J. Environ. Res. Public Health 2022, 19(20), 13268; https://doi.org/10.3390/ijerph192013268 - 14 Oct 2022

Cited by 4 | Viewed by 1564

Abstract

Background: An estimated 1.28 billion adults 30–79 years old had hypertension globally in 2021, of which two-thirds lived in low- and middle-income countries (LMICs). Previous studies on geographic and socioeconomic inequalities in hypertension among adults have limitations: (a) most studies used individual-level data, while evidence from locality-level data is also crucial for policymaking; (b) studies from LMICs are limited. Thus, our study examines geographic and socioeconomic inequalities in hypertension among adults across districts in Indonesia. Methods: We combined geospatial and quantitative analyses to assess the inequalities in hypertension across 514 districts in Indonesia. Hypertension data were obtained from the Indonesian Basic Health Survey (Riskesdas) 2018. Socioeconomic data were obtained from the World Bank. Six dependent variables included hypertension prevalence among all adults (18+ years), male adults, female adults, young adults (18–24 years), adults (25–59 years), and older adults (60+ years). Results: We also found significant geographic and socioeconomic inequalities in hypertension among adults across 514 districts. All hypertension indicators were higher in the most developed region than in the least developed region. Districts in the Java region had up to 50% higher prevalence of hypertension among all adults, males, females, young adults, adults, and older adults. Notably, districts in the Kalimantan region had the highest prevalence of hypertension, even compared to those in Java. Moreover, income level was positively associated with hypertension; the wealthiest districts had higher hypertension than the poorest districts by up to 30%, but only among males and older adults were statistically significant. Conclusions: There were significant inequalities in hypertension among adults across 514 districts in the country. Policies to reduce such inequalities may need to prioritize more affluent urban areas and rural areas with a higher burden. Full article

(This article belongs to the Special Issue Advances in the Health Effects of Place and Social Inequality)

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15 pages, 806 KiB

Open AccessArticle

How Income and Income Inequality Drive Depressive Symptoms in U.S. Adults, Does Sex Matter: 2005–2016

by Hossein Zare, Nicholas S. Meyerson, Chineze Adania Nwankwo and Roland J. Thorpe, Jr.

Int. J. Environ. Res. Public Health 2022, 19(10), 6227; https://doi.org/10.3390/ijerph19106227 - 20 May 2022

Cited by 10 | Viewed by 2363

Abstract

Importance: Depression is one of the leading causes of disability in the United States. Depression prevalence varies by income and sex, but more evidence is needed on the role income inequality may play in these associations. Objective: To examine the association between the Poverty to Income Ratio (PIR)—as a proxy for income—and depressive symptoms in adults ages 20 years and older, and to test how depression was concentrated among PIR. Design: Using the 2005–2016 National Health and Nutrition Examination Survey (NHANES), we employed Negative Binomial Regression (NBRG) in a sample of 24,166 adults. We used a 9-item PHQ (Public Health Questionnaire, PHQ-9) to measure the presence of depressive symptoms as an outcome variable. Additionally, we plotted a concentration curve to explain how depression is distributed among PIR. Results: In comparison with high-income, the low-income population in the study suffered more from greater than or equal to ten on the PHQ-9 by 4.5 and 3.5 times, respectively. The results of NBRG have shown that people with low-PIR (IRR: 1.30, 95% CI: 1.23–1.37) and medium-PIR (IRR: 1.55, 95% CI: 1.46–1.65) have experienced a higher relative risk ratio of having depressive symptoms. Women have a higher IRR (IRR: 1.29, 95% CI: 1.24–1.34) than men. We observed that depression was concentrated among low-PIR men and women, with a higher concentration among women. Conclusion and Relevance: Addressing depression should target low-income populations and populations with higher income inequality. Full article

(This article belongs to the Special Issue Advances in the Health Effects of Place and Social Inequality)

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13 pages, 1097 KiB

Open AccessArticle

The COVID-19 Vaccination and Vaccine Inequity Worldwide: An Empirical Study Based on Global Data

by Chuanlin Ning, Han Wang, Jing Wu, Qinwei Chen, Huacheng Pei and Hao Gao

Int. J. Environ. Res. Public Health 2022, 19(9), 5267; https://doi.org/10.3390/ijerph19095267 - 26 Apr 2022

Cited by 19 | Viewed by 3043

Abstract

Vaccination is critical for controlling the COVID-19 pandemic. However, the progress of COVID-19 vaccination varies from different countries, and global vaccine inequity has been a worldwide public health issue. This study collected data from the Our World in Data COVID-19 vaccination data set between 13 December 2020 and 1 January 2022. The measurement reflecting the pandemic situation included New cases, New deaths, Hospital patients, ICU patients, and the Reproduction rate. Indicators for measuring the vaccination coverage included Total vaccinations per hundred and People vaccinated per hundred. The Human Development Index (HDI) measured the country’s development level. Findings indicated that countries with higher HDI have more adequate vaccine resources, and global vaccine inequity exists. The study also found that vaccination significantly mitigates the pandemic, and reaching 70% immunization coverage can further control the epidemic. In addition, the emergence of Omicron variants makes the COVID-19 epidemic situation even worse, suggesting the importance and necessity of addressing vaccine inequity. The globe will face a greater challenge in controlling the pandemic if lower-vaccinated countries do not increase their vaccination coverage. Addressing the issue of vaccine inequity needs the cooperation of HIC, LMIC, public health departments, and vaccine producers. Moreover, the media has to contribute to effective public health communication by raising public perceptions of the COVID-19 pandemic, vaccination, and vaccine inequity. Full article

(This article belongs to the Special Issue Advances in the Health Effects of Place and Social Inequality)

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