Health Inequalities in Global Context

The existence of social inequalities in health is well established. One strand of research focuses on inequalities in health within a single country. A separate and newer strand of research focuses on the relationship between inequality and average population health across countries. Despite the theorization of (presumably variable) social conditions as “fundamental causes” of disease and health, the cross-national literature has focused on average, aggregate population health as the central outcome. Controversies currently surround macro-structural determinants of overall population health, such as income inequality. We advance and redirect these debates by conceptualizing inequalities in health as cross-national variables that are sensitive to social conditions. Using data from 48 World Values Survey countries, representing 74% of the world’s population, we examine cross-national variation in inequalities in health. The results reveal substantial variation in health inequalities according to income, education, sex, and migrant status. While higher socioeconomic position is associated with better self-rated health around the globe, the size of the association varies across institutional context and across dimensions of stratification. There is some evidence that education and income are more strongly associated with self-rated health than sex or migrant status

Bad Jobs, Bad Health? How Work and Working Conditions Contribute to Health Disparities

In this review, we touch on a broad array of ways that work is linked to health and health disparities for individuals and societies. First focusing on the health of individuals, we discuss the health differences between those who do and do not work for pay, and review key positive and negative exposures that can generate health disparities among the employed. These include both psychosocial factors like the benefits of a high-status job or the burden of perceived job insecurity, as well as physical exposures to dangerous working conditions like asbestos or rotating shift work. We also provide a discussion of the ways differential exposure to these aspects of work contributes to social disparities in health within and across generations. Analytic complexities in assessing the link between work and health for individuals, such as health selection, are also discussed. We then touch on several contextual-level associations between work and the health of populations, discussing the importance of the occupational structure in a given society, the policy environment that prevails there, and the oscillations of the macroeconomy for generating societal disparities in health. We close with a discussion of four areas and associated recommendations that draw on this corpus of knowledge but would push the research on work, health, and inequality toward even greater scholarly and policy relevance

"The Skill Is Using Your Big Head Over Your Little Head": What Black Heterosexual Men Say They Know, Want, and Need to Prevent HIV

Although the disproportionate toll of HIV/AIDS among Black heterosexuals, particularly in low-income U.S. urban areas is well documented, Black heterosexual men are rarely the explicit focus of HIV prevention messages, research, and interventions. We conducted 4 focus groups with 28 Black men, aged 19 to 51 years, who were enrolled in the workforce and fatherhood development program of a local community-based organization to examine (a) the priority and role of HIV/AIDS in their lives and (b) their HIV prevention needs. Although none articulated HIV as a top life priority, respondents nonetheless prioritized educating their children about HIV prevention and protecting their main partners from HIV if they had other sexual partners. Analyses demonstrated that participants said they wanted and needed: to learn how to talk to partners about HIV testing and use condoms when tempted not to do so, and more discussion-oriented educational opportunities to learn and exchange prevention strategies

Spatial Polygamy and Contextual Exposures (SPACEs): Promoting Activity Space Approaches in Research on Place And Health

Exposure science has developed rapidly and there is an increasing call for greater precision in the measurement of individual exposures across space and time. Social science interest in an individual’s environmental exposure, broadly conceived, has arguably been quite limited conceptually and methodologically. Indeed, in social science, we appear to lag behind our exposure science colleagues in our theories, data, and methods. In this article, we discuss a framework based on the concept of spatial polygamy to demonstrate the need to collect new forms of data on human spatial behavior and contextual exposures across time and space. Adopting new data and methods will be essential if one wants to better understand social inequality in terms of exposure to health risks and access to health resources. We discuss the opportunities and challenges focusing on the potential seemingly offered by focusing on human mobility and, specifically, the utilization of activity space concepts and data. A goal of the article is to spatialize social and health science concepts and research practice vis-à-vis the complexity of exposure. The article concludes with some recommendations for future research, focusing on theoretical and conceptual development promoting research on new types of places and human movement, the dynamic nature of contexts, and training