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Determinants of Social Inequalities in Health: New Perspectives for Policies Intervention

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

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 12334

Special Issue Editors

Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
Interests: determinants of health; public health studies; sociodemographic factors; work-related stress; health inequality disease
1. Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
2. The MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
Interests: molecular epidemiology; epigenetics; DNA methylation; aging; multi-omics

Special Issue Information

Dear Colleagues,

Inequalities in health and longevity by socioeconomic position have been observed for decades. This inverse and graded relationship in individuals is consistently observed both with educational and occupational status and is commonly known as the social gradient in health and disease. Although overall life expectancy and quality has increased over the past few decades, social differences in health and longevity have widened rather than declined in modern affluent societies.

The detrimental effect of poor social conditions on health operates through various mediating pathways, including unfavourable working conditions and economic hardship, decreased psychosocial resources, unhealthy lifestyle, environmental exposures, and access to care. It has been conceptualized under the notions of biological embedding or social-to-biological transitions that adverse social exposures may ultimately affect various biological processes related to health and survival, such as systemic inflammation, allostatic load, immune response, and epigenetic modifications. Additionally, recent evidence indicates that the unfavourable effects of low social conditions may be gender dependent.

To improve current knowledge on the determinants of social inequalities in health and understanding causality is crucial to develop public health policies, aiming to reduce social gradient in health and longevity. Researchers are strongly encouraged to submit research papers that can improve current knowledge in the field.

Prof. Dr. Guglielmo Campus
Prof. Dr. Giuliana Solinas
Dr. Giovanni Fiorito
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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

  • socio-economic disparities
  • public health studies
  • health policies
  • oral health
  • biomarkers
  • biostatistics

Published Papers (4 papers)

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Research

11 pages, 1356 KiB  
Article
County-Level Economic Changes and Drug Mortality in the United States: Evidence from the Great Recession
Int. J. Environ. Res. Public Health 2022, 19(23), 16261; https://doi.org/10.3390/ijerph192316261 - 05 Dec 2022
Viewed by 1036
Abstract
We aimed at examining whether county-level economic changes were associated with changes in county-level drug mortality rates since the Great Recession and whether the association is equally distributed across major sociodemographic subgroups. Using the Centers for Disease Control and Prevention’s Wide-Ranging Online Data [...] Read more.
We aimed at examining whether county-level economic changes were associated with changes in county-level drug mortality rates since the Great Recession and whether the association is equally distributed across major sociodemographic subgroups. Using the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (2004–2019), combined with census data, we conducted fixed effects analyses by including county-level economic changes as primary exposures and county-level drug-related mortality rates (per 100,000 people) from 2004–2007 (i.e., prior to the recession) to 2008–2011, 2012–2015, and 2016–2019 as an outcome variable based on 1833 counties. Our findings showed that drug mortality rates increased from 13.9 (2004–2007) to 16.0 (2008–2011), 18.0 (2012–2015), and 23.0 (2016–2019). Counties experiencing smaller median household income growth during and/or after the recession were associated with greater increase in drug mortality than counties experiencing larger median household income growth among the total population and all sociodemographic subgroups. Counties experiencing larger increases in unemployment rates and percentage of vacant housing units were associated with greater increase in drug mortality than counties experiencing smaller or no increase in unemployment rates and percentage of vacant housing units among certain sociodemographic subgroups. Findings suggest the importance of local economic contexts in understanding drug mortality risk since the recession. Drug overdose prevention polices need to be formulated by taking local economic changes following a major recession into consideration. Full article
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13 pages, 780 KiB  
Article
Oral Health in 12- and 15-Year-Old Children in Serbia: A National Pathfinder Study
Int. J. Environ. Res. Public Health 2022, 19(19), 12269; https://doi.org/10.3390/ijerph191912269 - 27 Sep 2022
Cited by 2 | Viewed by 1457
Abstract
The aim of the paper is to present the oral health profile of 12- and 15-year-old schoolchildren in Serbia. Basic Methods for Oral Health Surveys of the WHO were implemented to record: Decayed, Missing, and Filled Teeth/Surfaces Index (DMFT/DMFS), gingival bleeding, enamel fluorosis [...] Read more.
The aim of the paper is to present the oral health profile of 12- and 15-year-old schoolchildren in Serbia. Basic Methods for Oral Health Surveys of the WHO were implemented to record: Decayed, Missing, and Filled Teeth/Surfaces Index (DMFT/DMFS), gingival bleeding, enamel fluorosis and other structural anomalies, dental erosion, dental trauma, and oral mucosal lesions. In addition, Silness and Löe plaque index and orthodontic status were assessed. A total of 36% of 12-year-olds and 22% of 15-year-olds in Serbia were caries-free. The mean DMFT was 2.32 ± 2.69 for 12-year-olds and 4.09 ± 3.81 for 15-year-olds. DMFT was made up largely by the decayed component. Gingival bleeding was present in 26% of examined 12-year-old and 18% of 15-year-old children. Dental plaque was observed in 63% of both 12- and 15-year-olds. Fluorosis, structural anomalies, dental erosion, dental trauma, and oral mucosal lesion were rarely detected. Low prevalence of malocclusions was found. Oral disease is still a common public health problem among schoolchildren in Serbia. A significant increase in the prevalence of caries disease between 12- and 15-year-old groups implies that preventive care for adolescents requires special attention. Corrective actions and reforms to the current school-based oral health prevention program are needed to further improve oral health in Serbian children. Full article
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12 pages, 1179 KiB  
Article
Socioeconomic Inequalities in the Prevalence of Diabetes in Argentina: A Repeated Cross-Sectional Study in Urban Women and Men
Int. J. Environ. Res. Public Health 2022, 19(15), 8888; https://doi.org/10.3390/ijerph19158888 - 22 Jul 2022
Cited by 1 | Viewed by 1304
Abstract
This study measured the socioeconomic inequalities in the prevalence of diabetes between 2005 and 2018 in an urban Argentinian population. Data were obtained from the repeated cross-sectional surveys “National Survey of Risk Factors” (ENFR is its acronym in Spanish). From 2005 to 2018, [...] Read more.
This study measured the socioeconomic inequalities in the prevalence of diabetes between 2005 and 2018 in an urban Argentinian population. Data were obtained from the repeated cross-sectional surveys “National Survey of Risk Factors” (ENFR is its acronym in Spanish). From 2005 to 2018, four rounds of ENFR were administered to men and women over 18 years of age. Concentration curves (CC) and the Erreygers concentration index (ECI) were used to describe the socioeconomic inequalities in diabetes’ prevalence. A decomposition analysis was performed to determine the contribution of each variable to inequality in diabetes’ prevalence. Data from 41,219 (2005), 34,583 (2009), 32,232 (2013), and 29,094 (2018) individuals were analyzed. Women reported a greater prevalence of diabetes compared with men for all the years included. According to the CC and ECI, we found no evidence of inequality in men throughout all study years. For women, throughout all years, the CCs were above the line of equity, and the ECIs during all the years were negative and different from zero (p < 0.01). For women, we found no evidence of a reduction in inequalities between 2005 and 2018 (p = 0.475). The socioeconomic inequality for women was largely driven by public insurance, primary and secondary education, and employment. Diabetes’ prevalence was not associated with socioeconomic status in men, while the prevalence of diabetes in women was more concentrated among poorer women. During the 13 years, there was no evidence of a reduction of inequality in women, noting that interventions must prioritize and should focus on the main contribution of inequalities, such as education and employment. Full article
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17 pages, 2277 KiB  
Article
A Theoretical Perspective on Why Socioeconomic Health Inequalities Are Persistent: Building the Case for an Effective Approach
Int. J. Environ. Res. Public Health 2022, 19(14), 8384; https://doi.org/10.3390/ijerph19148384 - 08 Jul 2022
Cited by 7 | Viewed by 7753
Abstract
Despite policy intentions and many interventions aimed at reducing socioeconomic health inequalities in recent decades in the Netherlands and other affluent countries, these inequalities have not been reduced. Based on a narrative literature review, this paper aims to increase insight into why socioeconomic [...] Read more.
Despite policy intentions and many interventions aimed at reducing socioeconomic health inequalities in recent decades in the Netherlands and other affluent countries, these inequalities have not been reduced. Based on a narrative literature review, this paper aims to increase insight into why socioeconomic health inequalities are so persistent and build a way forward for improved approaches from a theoretical perspective. Firstly, we present relevant theories focusing on individual determinants of health-related behaviors. Thereafter, we present theories that take into account determinants of the individual level and the environmental level. Lastly, we show the complexity of the system of individual determinants, environmental determinants and behavior change for low socioeconomic position (SEP) groups and describe the next steps in developing and evaluating future effective approaches. These steps include systems thinking, a complex whole-system approach and participation of all stakeholders in system change. Full article
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