79 research outputs found

    Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems

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    Background Educational inequalities in health and mortality in European countries have often been studied in the context of welfare regimes or political systems. We argue that the healthcare system is the national level feature most directly linkable to mortality amenable to healthcare. In this article, we ask to what extent the strength of educational differences in mortality amenable to healthcare vary among European countries and between European healthcare system types. Methods This study uses data on mortality amenable to healthcare for 21 European populations, covering ages 35–79 and spanning from 1998 to 2006. ISCED education categories are used to calculate relative (RII) and absolute inequalities (SII) between the highest and lowest educated. The healthcare system typology is based on the latest available classification. Meta-analysis and ANOVA tests are used to see if and how they can explain between-country differences in inequalities and whether any healthcare system types have higher inequalities. Results All countries and healthcare system types exhibited relative and absolute educational inequalities in mortality amenable to healthcare. The low-supply and low performance mixed healthcare system type had the highest inequality point estimate for the male (RII = 3.57; SII = 414) and female (RII = 3.18; SII = 209) population, while the regulation-oriented public healthcare systems had the overall lowest (male RII = 1.78; male SII = 123; female RII = 1.86; female SII = 78.5). Due to data limitations, results were not robust enough to make substantial claims about typology differences. Conclusions This article aims at discussing possible mechanisms connecting healthcare systems, social position, and health. Results indicate that factors located within the healthcare system are relevant for health inequalities, as inequalities in mortality amenable to medical care are present in all healthcare systems. Future research should aim at examining the role of specific characteristics of healthcare systems in more detail.Peer reviewe

    Australians’ views on carbon pricing before and after the 2013 federal election

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    As climate policies change through the legislative process, public attitudes towards them may change as well. Therefore, it is important to assess how people accept and support controversial climate policies as the policies change over time. Policy acceptance is a positive evaluation of, or attitude towards, an existing policy; policy support adds an active behavioural component1, 3. Acceptance does not necessarily lead to support. We conducted a national survey of Australian residents to investigate acceptance of, and support for, the Australian carbon pricing policy before and after the 2013 federal election, and how perceptions of the policy, economic ideology, and voting behaviour affect acceptance and support. We found acceptance and support were stable across the election period, which was surprising given that climate policy was highly contentious during the election. Policy acceptance was higher than policy support at both times and acceptance was a necessary but insufficient condition of support. We conclude that acceptance is an important process through which perceptions of the policy and economic ideology influence support. Therefore, future climate policy research needs to distinguish between acceptance and support to better understand this process, and to better measure these concepts

    User experiences with simulated cyber‑physical attacks on smart home IoT

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    With the Internet of Things (IoT) becoming increasingly prevalent in people’s homes, new threats to residents are emerging such as the cyber-physical attack, i.e. a cyber-attack with physical consequences. In this study, we aimed to gain insights into how people experience and respond to cyber-physical attacks to their IoT devices. We conducted a naturalistic field experiment and provided 9 Dutch and 7 UK households, totalling 18 and 13 participants respectively, with a number of smart devices for use in their home. After a period of adaptation, simulated attacks were conducted, leading to events of varying noticeability (e.g., the light going on or off once or several times). After informing people simulated attacks had occurred, the attacks were repeated one more time. User experiences were collected through interviews and analysed with thematic analyses. Four relevant themes were identified, namely (1) the awareness of and concern about privacy and security risks was rather low, (2) the simulated attacks made little impression on the participants, (3) the participants had difficulties with correctly recognizing simulated attacks, and (4) when informed about simulated attacks taking place; participants noticed more simulated attacks and presented decision rules for them (but still were not able to identify and distinguish them well—see Theme 3). The findings emphasise the need for training interventions and an intrusion detection system to increase detection of cyber-physical attacks.European Union funding: G0H6416N-FWOOPR201600970; Engineering and Physical Sciences Research Council (EPSRC): EP/P016448/1; NWO: 651.002.00

    Impact of small vessel disease in the brain on gait and balance

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    Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71–74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity – WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients’ performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects

    The role of income inequality and social policies on income-related health inequalities in Europe

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    INTRODUCTION: The aim of the paper is to examine the role of income inequality and redistribution for income-related health inequalities in Europe. This paper contributes in two ways to the literature on macro determinants of socio-economic inequalities in health. First, it widens the distinctive focus of the research field on welfare state regimes to quantifiable measures such as social policy indicators. Second, looking at income differences completes studies on socio-economic health inequalities, which often analyse health inequalities based on educational differences. METHODS: Using data from the European Values Study (2008/2009), 42 European countries are available for analysis. Country characteristics are derived from SWIID, Eurostat, and ILO and include indicators for income inequality, social policies, and economic performance. The data is analysed by using a two-step hierarchical estimation approach: At the first step—the individual level—the effect of household income on self-assessed health is extracted and introduced as an indicator measuring income-related health inequalities at the second step, the country-level. RESULTS: Individual-level analyses reveal that income-related health inequalities exist all across Europe. Results from country-level analyses show that higher income inequality is significantly positively related to higher health inequalities while social policies do not show significant relations. Nevertheless, the results show the expected negative association between social policies and health inequalities. Economic performance also has a reducing influence on health inequalities. In all models, income inequality was the dominating explanatory effect for health inequalities. CONCLUSIONS: The analyses indicate that income inequality has more impact on health inequalities than social policies. On the contrary, social policies seemed to matter to all individuals regardless of socio-economic position since it is significantly positively linked to overall population health. Even though social policies are not significantly related to health inequalities, the power of public redistribution to impact health inequalities should not be downplayed. Social policies as a way of public redistribution are a possible instrument to reduce income inequalities which would in turn lead to a reduction in health inequalities

    The Happiest Kids on Earth : Gender Equality and Adolescent Life Satisfaction in Europe and North America

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    Cross-national differences in adolescent life satisfaction in Europe and North America are consistent, but remain poorly understood. While previous studies have predominantly focused on the explanatory role of economic factors, such as national wealth and income equality, they revealed weak associations, at most. This study examines whether societal gender equality can explain the observed cross-national variability in adolescent life satisfaction. Based on the assumption that gender equality fosters a supportive social context, for example within families through a more equal involvement of fathers and mothers in child care tasks, adolescent life satisfaction was expected to be higher in more gender-equal countries. To test this hypothesis, national-level data of gender equality (i.e., women’s share in political participation, decision making power, economic participation and command over resources) were linked to data from 175,470 adolescents aged 11–16 years old (Mage = 13.6, SD = 1.64, 52% girls) from 34 European and North American countries involved in the 2009/10 Health Behaviour in School-aged Children (HBSC) study. Results of linear multilevel regression analyses indicate that adolescents in countries with relatively high levels of gender equality report higher life satisfaction than their peers in countries with lower levels of gender equality. The association between gender equality and adolescent life satisfaction remained significant after controlling for national wealth and income equality. It was equally strong for boys and girls. Moreover, the association between gender equality and life satisfaction was explained by social support in the family, peer and school context. This analysis suggests that gender equality fosters social support among members of a society, which in turn contributes to adolescent life satisfaction. Thus, promoting gender equality is likely to benefit all members of a society; not just by giving equal rights to women and girls, but also by fostering a supportive social climate for all

    Imigração e saúde: a (in)acessibilidade das mulheres imigrantes aos cuidados de saúde

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    A utilização dos serviços de saúde pelas populações imigrantes tem vindo a ser considerado um dos mais importantes indicadores da sua integração nas so- ciedades receptoras (Dias e col., 2009). No entanto, o conhecimento em torno da qualidade e da eficácia do acesso dos/as imigrantes aos cuidados de saúde, especialmente no que respeita às mulheres imigran- tes, é ainda escasso em Portugal (Fonseca e col., 2005). Embora os estudos nacionais tenham vindo, nas últimas décadas, a procurar traçar os diferentes perfis sociais das mulheres imigrantes em Portugal, sobretudo no que concerne às suas relações fami- liares ou laborais (Wall e col., 2005), a investigação no domínio da saúde é ainda parca e exclusora de uma análise centrada no género ou interseccional. Neste texto apresenta-se uma reflexão sobre os de- terminantes que condicionam a (in)acessibilidade das mulheres imigrantes aos cuidados de saúde, enfatizando-se os fatores que poderão estar a agir no sentido contrário à sua integração neste setor
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