Methods for Measuring Cancer Disparities: Using Data Relevant to Healthy People 2010 Cancer-Related Objectives

Healthy People 2010 has two overarching goals: to increase the span of healthy life and to eliminate health disparities across the categories of gender, race or ethnicity, education or income, disability, geographic location, and sexual orientation (1). This report raises some conceptual issues and reviews different methodological approaches germane to measuring progress toward the goal of eliminating cancer-related health disparities (2). Despite the increased attention to social disparities in health, no clear framework exists to define and measure health disparities. This may create confusion in communicating the extent of cancer-related health disparities and hinder the ability of public health organizations to monitor progress toward the Healthy People 2010 cancer objectives

Socioeconomic inequality in neonatal mortality in countries of low and middle income: a multicountry analysis

Background Neonatal mortality rates (NMRs) in countries of low and middle income have been only slowly decreasing; coverage of essential maternal and newborn health services needs to increase, particularly for disadvantaged populations. Our aim was to produce comparable estimates of changes in socioeconomic inequalities in NMR in the past two decades across these countries. Methods We used data from Demographic and Health Surveys (DHS) for countries in which a survey was done in 2008 or later and one about 10 years previously. We measured absolute inequalities with the slope index of inequality and relative inequalities with the relative index of inequality. We used an asset-based wealth index and maternal education as measures of socioeconomic position and summarised inequality estimates for all included countries with random-eff ects meta-analysis. Findings 24 low-income and middle-income countries were eligible for inclusion. In most countries, absolute and relative wealth-related and educational inequalities in NMR decreased between survey 1 and survey 2. In fi ve countries (Cameroon, Nigeria, Malawi, Mozambique, and Uganda), the diff erence in NMR between the top and bottom of the wealth distribution was reduced by more than two neonatal deaths per 1000 livebirths per year. By contrast, wealthrelated inequality increased by more than 1·5 neonatal deaths per 1000 livebirths per year in Ethiopia and Cambodia. Patterns of change in absolute and relative educational inequalities in NMR were similar to those of wealth-related NMR inequalities, although the size of educational inequalities tended to be slightly larger. Interpretation Socioeconomic inequality in NMR seems to have decreased in the past two decades in most countries of low and middle income. However, a substantial survival advantage remains for babies born into wealthier households with a high educational level, which should be considered in global eff orts to further reduce NMR

Evidence that digital game players neglect age classification systems when deciding which games to play

This article considers players\u27 experiences seeking out new games to play, and their use of the Australian National Classification Scheme in doing so. The global video game industry is booming, with hundreds of games being released each month across numerous platforms. As a result, players have an unprecedented number of games available when choosing what games to purchase. However, a number of confounding issues around the emergent content of games and the subjective nature of game reviewing makes it difficult to relate what kinds of experiences a given game will facilitate. In this study, we surveyed game players in order to find their game platform and acquisition preferences; strategies and experiences when choosing games; and attitudes towards classification systems. Our findings suggest that players find it difficult to choose what games to purchase, and that existing classification systems are mostly only beneficial when choosing games for minors

Global and National Socioeconomic Disparities in Obesity, Overweight, and Underweight Status

Objective. To examine the association between socioeconomic factors and weight status across 53 countries. Methods. Data are cross-sectional and from the long version of the World Health Survey (WHS). There were 172,625 WHS participants who provided self-reported height and weight measures and sociodemographic information. The International Classification of adult weight status was used to classify participants by body mass index (BMI): (1) underweight (<18.5), (2) normal weight (18.5–24.9), (3) overweight (25.0–29.9), and (4) obese (>30.0). Multinomial regression was used in the analyses. Results. Globally, 6.7% was underweight, 25.7% overweight, and 8.9% obese. Underweight status was least (5.8%) and obesity (9.3%) most prevalent in the richest quintile. There was variability between countries, with a tendency for lower-income quintiles to be at increased risk for underweight and reduced risk for obesity. Conclusion. International policies may require flexibility in addressing cross-national differences in the socio-economic covariates of BMI status

The effects of supported housing for individuals with mental disorders

Societies face the challenge of providing appropriate arrangements for individuals who need living support due to their mental disorders. We estimate the effects of eligibility to the Dutch supported housing program (Beschermd Wonen), which offers a structured living environment in the community as an intermediate alternative to independent housing and inpatient care. For this, we use exogenous variation in eligibility based on conditionally random assignment of applications to assessors, and the universe of applications to supported housing in the Netherlands, linked to rich administrative data. Supported housing eligibility increases the probability of moving into supported housing and decreases the use of home care, resulting in higher total care expenditures. This increase is primarily due to the costs of supported housing, but potentially also higher consumption of curative mental health care. Supported housing eligibility reduces the total personal income and income from work. Findings do also suggest lower participation in the labor market by the individuals granted eligibility, but the labor participation of their parents increases in the long‐run. Our study highlights the trade‐offs of access to supported housing for those at the margin of eligibility, informing the design of long‐term mental health care systems around the world

Unlocking Electric Cooking on Nepali Micro-Hydropower Mini-Grids

Electric cooking has the potential to improve quality of life for people who cook using biomass, both by improving health by eradicating harmful emissions and by removing the need to collect fuelwood, thus freeing up time for other activities. This paper reports on a study that introduced electric cooking as an alternative to biomass-based cooking in 10 households in Simli, a rural Western Nepali community, to assess its feasibility in rural off-grid contexts. Quantitative and qualitative data from a cooking diary study and electrical mini-grid data were collected, assessing the compatibility with micro-hydropower grids and Nepali cooking practices. Datasets of Nepali cooking practices and meal energy requirements were generated, revealing that generally two meals are cooked per day and that, on average, electric cooking consumes 0.25 kWh/day and 0.14 kWh/meal. Participants simplified their cooking practices and found chapati hard to cook on the induction hobs due to inexperience with the cookers. Conversely, dal and rice were found to be easy and fast to cook in pressure cookers on the hobs, leading to a switch from cooking chapati-vegetables based meals to dal-rice based meals. Fuel stacking was common, with participants reverting to their biomass stoves to cook chapati, and due to a lack of reliable electricity supply. Participants found that the transition to electric cooking provided more time for households, due to the reduction in length of time to cook a meal and less time required to collect firewood, and enjoyed cooking on the stoves due to elimination of indoor air pollution. The electrical data analysis showed that control issues, voltage instability, and limited micro-hydropower plant capacity provide obstacles for electric cooking, especially as it becomes more widely practiced. Nepali people typically cook at the same time as peak demand for electricity, exacerbating the problem of limited capacity in villages like Simli. Only three households continued to use their electric stoves regularly due to a lack of reliable electricity supply, showing that widespread adoption of electric cooking is currently unfeasible. The running costs of electric cooking were lower than the effective labour time costs of fuelwood collection, but initial capital expenses for the electric cooking system and monthly electricity costs are a further barrier to adoption in rural Nepal