Welfare state and representation: do women make the welfare state or does the welfare state make women representatives?

The relationship between welfare states and women’s representation in parliaments has been of great interest to scholars. However, different strands of the literature on gender and political representation suggest opposing directions of causality. On the one hand it is argued that a rise in welfare spending increases women’s representation in parliaments, but on the other hand, more women in parliaments is said to expand welfare spending. This paper analyses the problem empirically and finds that the lagged values of women’s parliamentary representation are better predictors of welfare spending than the lagged values of spending are of women’s percent in parliaments. In other words, women make the welfare state and welfare spending does not make female representatives

“There goes the fear”: Feelings of safety at home and in the neighbourhood: the role of personal, social and service factors

Safety has been shown to be an important contributor to mental wellbeing and is often identified as a key element of sustainable communities. Drawing on the fear of crime literature this paper investigates the determinants of feelings of indoor and outdoor safety for people living in deprived areas, using both cross-sectional and longitudinal samples from household surveys in 15 communities in Glasgow. Across the different models social cohesion, satisfaction with services and perceived empowerment emerge as the most robust predictors of feeling very safe indoors and outside. Our findings suggest useful extensions to several theoretical models of the fear of crime: the vulnerability hypothesis should include social vulnerability more generally; environmental models should focus on local amenities and services as well as on disorder; and social-psychological models should consider not only informal social control but resident empowerment in relation to housing and neighbourhood issues

Carstairs Scores for Scottish Postcode Sectors, Datazones and Output Areas from the 2011 Census

Carstairs deprivation scores, originally created in 1981, provide a measure of material deprivation. Four census variables (male unemployment, no car ownership, overcrowding and low social class) were used in the creation of the score. As near as possible the same four variables have been used to update Carstairs scores decennially, despite changes to the definition of some of the variables over time. Researchers at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow have now updated Carstairs scores for 2011 for Scottish postcode sectors and for the first time datazones and output areas

Differences in ill health and in socioeconomic inequalities in health by ethnic groups: a cross-sectional study using 2011 Scottish Census

Objectives: We compare rates of ill health and socioeconomic inequalities in health by ethnic groups in Scotland by age. We focus on ethnic differences in socioeconomic inequalities in health. There is little evidence of how socioeconomic inequalities in health vary by ethnicity, especially in Scotland, where health inequalities are high compared to other European countries. Design: A cross-sectional study using the 2011 Scottish Census (population 5.3 million) was conducted. Directly standardized rates were calculated for two self-rated health outcomes (poor general health and limiting long-term illness) separately by ethnicity, age and small-area deprivation. Slope and relative indices of inequality were calculated to measure socioeconomic inequalities in health. Results: The results show that the White Scottish population tend to have worse health and higher socioeconomic inequalities in health than many other ethnic groups, while White Polish and Chinese people tend to have better health and low socioeconomic inequalities in health. These results are more salient for ages 30–44. The Pakistani population has high rates of poor health similar to the White Scottish for ages 15–44, but at ages 45 and above Pakistani people have the highest rates of poor self-rated health. Compared to other ethnicities, Pakistani people are also more likely to experience poor health in the least deprived areas, particularly at ages 45 and above. Conclusions: There are statistically significant and substantial differences in poor self-rated health and in socioeconomic inequalities in health between ethnicities. Rates of ill health vary between ethnic groups at any age. The better health of the younger minority population should not be taken as evidence of better health outcomes in later life. Since socioeconomic gradients in health vary by ethnicity, policy interventions for health improvement in Scotland that focus only on deprived areas may inadvertently exclude minority populations

Creating small-area deprivation indices: a guide for stages and options

Small-area composite measures (such as for deprivation, geographic access or green space) have become increasing popular among both researchers and policy makers and are frequently used to compare or rank areas. Because of their seeming simplicity and wide appeal, it is important to set out for researchers and users the different stages and options that underlie the development of composite indices. Using small area deprivation measures as an example, this article reviews the key decisions faced by researchers from choosing the data and variables to validation and measuring uncertainty. Our aim is to guide researchers in the planning and following through with the process of developing a small-area measure. To date, the different choices are often not considered and the methodological decisions tend to be based on tradition or convenience. While there is no widely accepted framework for choosing between methods, we argue that researchers should compare different methods and justify their decisions at each stage of the process. In particular, more emphasis should be put on validating measures for different population subgroups

Longitudinal study of diabetes prevalence and hospitalisations among care experienced and general population children in Scotland : evidence of an end of care "cliff edge"?

Objectives Care experienced people have poorer health in UK and internationally, but the direction of causation is debated. Using longitudinal cross-sectoral data linkage we explore if inequalities in diabetes prevalence and hospitalisation are present before entering care or develop during or after leaving care. Approach Health and social care data were linked for 13,830 care experienced children (CEC) and together with 649,771 general population children (GPC) their prescriptions and hospitalisations were followed from birth between 1990-2004 to study end in 2016. Diabetes prevalence was estimated as at least one prescription or inpatient hospitalisation for diabetes. We compared hospitalisation percentages and rates in the two cohorts by age and gender. Results from multivariable models adjusted for socioeconomic status, age, gender, care type/length, local authority, and comorbidities will be presented at conference. Results Diabetes prevalence was similar in both cohorts and higher in females. However, CEC had twice as many hospitalisations as GPC. Mean hospitalisations were highest among care experienced males (6 compared to 3.6 in females and 2 in GPC). 24% of CEC were hospitalised 3-9 times and 13% 10+ times, for GPC these were 19% and 3% respectively. Hospitalisation rates increase with age in both cohorts, as do differences between cohorts. At ages 0-4 hospitalisation rates are similar, by ages 12-15 CEC have twice as high and at ages 18-27 4-times higher hospitalisation rates. Among CEC, across all ages hospitalisation rates are lower while the child is in care, with the lowest rates in foster care. Hospitalisation rates are highest before entering and after leaving care. Conclusion Results for diabetes hospitalisations suggest that being in care can be good for children’s health. However, a sudden withdrawal of support can create a “cliff edge” and health may deteriorate after leaving care. Data linkage has significant potential to inform policy and practice, including supporting CEC after leaving care

Deaths of despair: Cause-specific mortality and socioeconomic inequalities in cause-specific mortality among young men in Scotland

Background: Increasing mortality among men from drugs, alcohol and suicides is a growing public health concern in many countries. Collectively known as “deaths of despair”, they are seen to stem from unprecedented economic pressures and a breakdown in social support structures. Methods: We use high-quality population wide Scottish data to calculate directly age-standardized mortality rates for men aged 15–44 between 1980 and 2018 for 15 leading causes of mortality. Absolute and relative inequalities in mortality by cause are calculated using small-area deprivation and the slope and relative indices of inequality (SII and RIIL) for the years 2001–2018. Results: Since 1980 there have been only small reductions in mortality among men aged 15–44 in Scotland. In that period drug-related deaths have increased from 1.2 (95% CI 0.7–1.4) to 44.9 (95% CI 42.5–47.4) deaths per 100,000 and are now the leading cause of mortality. Between 2001 and 2018 there have been small reductions in absolute but not in relative inequalities in all-cause mortality. However, absolute inequalities in mortality from drugs have doubled from SII = 66.6 (95% CI 61.5–70.9) in 2001–2003 to SII = 120.0 (95% CI 113.3–126.8) in 2016–2018. Drugs are the main contributor to inequalities in mortality, and together with alcohol harm and suicides make up 65% of absolute inequalities in mortality. Conclusions: Contrary to the substantial reductions in mortality across all ages in the past decades, deaths among young men are increasing from preventable causes. Attempts to reduce external causes of mortality have focused on a single cause of death and not been effective in reducing mortality or inequalities in mortality from external causes in the long-run. To reduce deaths of despair, action should be taken to address social determinants of health and reduce socioeconomic inequalities

Physical health of care-experienced young children in high-income countries: a scoping review protocol

Introduction: Care-experienced children have poorer health, developmental, and quality of life outcomes across the lifespan compared to children who are not in care. These inequities begin to manifest in the early years. The purpose of the proposed scoping review is to collate and synthesise studies of the physical health of young care-experienced children. The results of the review will help map the distribution of health outcomes, identify potential targets for intervention, and assess gaps in the literature relating to this group. Methods and analysis: We will carry out a scoping review of the literature to identify studies of physical health outcomes in care-experienced children. Systematic literature searches will be carried out on the MEDLINE, CINAHL and Web of Science Core Collection databases for items indexed on or before 31 August 2022. Studies will be included where the participants are aged 3 months or greater and less than 6 years. Data elements extracted from included studies will include study objectives, health outcomes, participant demographics, care setting characteristics and bibliographic information. The results of the review will be synthesised and reported using a critical narrative approach. Comparisons between care and non-care populations will be reported if sufficient studies are identified. Ethics and dissemination: Data will be extracted from publicly available sources, so no additional ethical approval is required. Results will be published in a peer-reviewed journal article. Furthermore, they will be shared in summary reports and presented to local authorities, care organisations and other relevant stakeholders that can influence healthcare policy and procedure relating to young children in care

Developing a Small-Area Deprivation Measure for Brazil

This report describes the development of the BrazDep small-area deprivation measure for the whole of Brazil. The measure uses the 2010 Brazilian Population Census data and is calculated for the smallest possible geographical area level, the census sectors. It combines three variables – (1) percent of households with per capita income ≤ 1/2 minimum wage; (2) percent of people not literate, aged 7+; and (3) average of percent of people with inadequate access to sewage, water, garbage collection and no toilet and bath/shower – into a single measure. Similar measures have previously been developed at the census sector level for some states or municipalities, but the deprivation measure described in this report is the first one to be provided for census sectors for the whole of Brazil. BrazDep is a measure of relative deprivation, placing the census sectors on a scale of material well-being from the least to the most deprived. It is useful in comparing areas within Brazil in 2010, but cannot be used to make comparisons across countries or time. Categorical versions of the measure are also provided, placing census sectors into groups of similar levels of deprivation. Deprivation measures, such as the one developed here, have been developed for many countries and are popular tools in public health research for describing the social patterning of health outcomes and supporting the targeting and delivery of services to areas of higher need. The deprivation measure is exponentially distributed, with a large proportion of areas having a low deprivation score and a smaller number of areas experiencing very high deprivation. There is significant regional variation in deprivation; areas in the North and Northeast of Brazil have on average much higher deprivation compared to the South and Southeast. Deprivation levels in the Central-West region fall between those for the North and South. Differences are also great between urban and rural areas, with the former having lower levels of deprivation compared to the latter. The measure was validated by comparing it to other similar indices measuring health and social vulnerability at the census sector level in states and municipalities where it was possible, and at the municipal level for across the whole of Brazil. At the municipal level the deprivation measure was also compared to health outcomes. The different validation exercises showed that the developed measure produced expected results and could be considered validated. As the measure is an estimate of the “true” deprivation in Brazil, uncertainty exists about the exact level of deprivation for all of the areas. For the majority of census sectors the uncertainty is small enough that we can reliably place the area into a deprivation category. However, for some areas uncertainty is very high and the provided estimate is unreliable. These considerations should always be kept in mind when using the BrazDep measure in research or policy. The measure should be used as part of a toolkit, rather than a single basis for decision-making. The data together with documentation is available from the University of Glasgow http: //dx.doi.org/10.5525/gla.researchdata.980. The data and this report are distributed under Creative Commons Share-Alike license (CC BY-SA 4.0) and can be freely used by researchers, policy makers or members of public