Poverty, Income Inequality and Health

The purpose of this report is to consider the legitimacy of the assumption that communities or societies with more unequal income distributions have poorer health outcomes. We present a critical review of the existing international literature on the relationship between income, income inequality and health, in terms of conceptual approaches, research methods and the policy implications drawn from it. Where possible, we also offer some guidance for judging between policy priorities based on the relative importance of income inequality versus other potential causal factors in determining population levels of health. An overview of the potential relationship between income, income inequality and health is set out, followed by a discussion of the methodological and technical issues required to explore these links. A literature review of what we consider to be the key contributions in the income inequality - health debate is presented, as is a re-analysis of data derived from Chapter 3 of Social Inequalities in Health: New Zealand 1999, which focuses on income, income inequality and health. We conclude that the relative effect of income inequality per se as a determinant of population health has been greatly exaggerated. The frequently observed association between income inequality and health at the regional level is likely to be a by-product of the non-linear relationship between individual income and health, although we cannot dismiss the possibility that income inequality may also act as a marker for other area characteristics that influence health. We stress that a life course approach is paramount for any study into the relationship between poverty and health, while the use of multi-level data analysis is fundamental in attempting to establish the relationship between income distribution and area level health status.poverty, income, income inequality, population health, health inequalities, life course studies, aggregate studies, multi-level studies.

Evidence on the relationship between income and poor health: is the government doing enough?

The government’s report, Opportunity for All: Tackling Poverty and Social Exclusion (Department of Social Security, 1999), identified poor health as one of the major problems associated with low income. However, much of the available evidence on the relationship between income and health is of little help in forming policies to reduce health inequalities, as it has tended to be based on cross-section surveys and is therefore unable to shed much light on causal effects. Here, we make use of two British longitudinal datasets to examine the longer-term influences of income on health within a life-course perspective. We then use the results of our analysis to provide a brief critical assessment of the likely success of the government’s anti-poverty strategy in reducing health inequalities. A more detailed assessment of government policy in this respect can be found in Benzeval et al. (forthcoming).

Search for New Physics in Rare Top Decays: ttˉt \bar t Spin Correlations and Other Observables

In this paper we study new-physics contributions to the top-quark decay $t \to b \bar b c$. We search for ways of detecting such new physics via measurements at the LHC. As top quarks are mainly produced at the LHC in $t \bar t$ production via gluon fusion, we analyze the process $gg \to t \bar t \to (b \bar b c) (\bar b \ell \bar \nu)$. We find six observables that can be used to reveal the presence of new physics in $t \to b \bar b c$. Three are invariant mass-squared distributions involving two of the final-state particles in the top decay, and three are angular correlations between the final-state quarks coming from the $t$ decay and the $\ell^-$ coming from the $\bar t$ decay. The angular correlations are related to the $t \bar t$ spin correlation.Comment: Published versio

Search for new physics in rare top decays: t¯t spin correlations and other observables

In this paper we study new-physics contributions to the top-quark decay t → bbc. We search for ways of detecting such new physics via measurements at the LHC. As top quarks are mainly produced at the LHC in tt production via gluon fusion, we analyze the process gg → tt → bbc bℓν . We find six observables that can be used to reveal the presence of new physics in t → bbc. Three are invariant mass-squared distributions involving two of the final-state particles in the top decay, and three are angular correlations between the final-state quarks coming from the t decay and the ℓ − coming from the t decay. The angular correlations are related to the t t spin correlation.Instituto de Física La Plat

Search for new physics in rare top decays: t¯t spin correlations and other observables

In this paper we study new-physics contributions to the top-quark decay t → bbc. We search for ways of detecting such new physics via measurements at the LHC. As top quarks are mainly produced at the LHC in tt production via gluon fusion, we analyze the process gg → tt → bbc bℓν . We find six observables that can be used to reveal the presence of new physics in t → bbc. Three are invariant mass-squared distributions involving two of the final-state particles in the top decay, and three are angular correlations between the final-state quarks coming from the t decay and the ℓ − coming from the t decay. The angular correlations are related to the t t spin correlation.Instituto de Física La Plat

International children's accelerometry database (ICAD): design and methods.

BACKGROUND: Over the past decade, accelerometers have increased in popularity as an objective measure of physical activity in free-living individuals. Evidence suggests that objective measures, rather than subjective tools such as questionnaires, are more likely to detect associations between physical activity and health in children. To date, a number of studies of children and adolescents across diverse cultures around the globe have collected accelerometer measures of physical activity accompanied by a broad range of predictor variables and associated health outcomes. The International Children's Accelerometry Database (ICAD) project pooled and reduced raw accelerometer data using standardized methods to create comparable outcome variables across studies. Such data pooling has the potential to improve our knowledge regarding the strength of relationships between physical activity and health. This manuscript describes the contributing studies, outlines the standardized methods used to process the accelerometer data and provides the initial questions which will be addressed using this novel data repository. METHODS: Between September 2008 and May 2010 46,131 raw Actigraph data files and accompanying anthropometric, demographic and health data collected on children (aged 3-18 years) were obtained from 20 studies worldwide and data was reduced using standardized analytical methods. RESULTS: When using ≥ 8, ≥ 10 and ≥ 12 hrs of wear per day as a criterion, 96%, 93.5% and 86.2% of the males, respectively, and 96.3%, 93.7% and 86% of the females, respectively, had at least one valid day of data. CONCLUSIONS: Pooling raw accelerometer data and accompanying phenotypic data from a number of studies has the potential to: a) increase statistical power due to a large sample size, b) create a more heterogeneous and potentially more representative sample, c) standardize and optimize the analytical methods used in the generation of outcome variables, and d) provide a means to study the causes of inter-study variability in physical activity. Methodological challenges include inflated variability in accelerometry measurements and the wide variation in tools and methods used to collect non-accelerometer data.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Did the English strategy reduce inequalities in health? A difference-in-difference analysis comparing England with three other European countries

Background: Between 1997 and 2010, the English government pursued an ambitious programme to reduce health inequalities, the explicit and sustained commitment of which was historically and internationally unique. Previous evaluations have produced mixed results. None of these evaluations have, however, compared the trends in health inequalities within England with those in other European countries. We carried out an innovative analysis to assess whether changes in trends in health inequalities observed in England after the implementation of its programme, have been more favourable than those in other countries without such a programme. Methods: Data were obtained from nationally representative surveys carried out in England, Finland, the Netherlands and Italy for years around 1990, 2000 and 2010. A modified difference-in-difference approach was used to assess whether trends in health inequalities in 2000-2010 were more favourable as compared to the period 1990-2000 in England, and the changes in trends in inequalities after 2000 in England were then compared to those in the three comparison countries. Health outcomes were self-assessed health, long-standing health problems, smoking status and obesity. Education was used as indicator of socioeconomic position. Results: After the implementation of the English strategy, more favourable trends in some health indicators were observed among low-educated people, but trends in health inequalities in 2000-2010 in England were not more favourable than those observed in the period 1990-2000. For most health indicators, changes in trends of health inequalities after 2000 in England were also not significantly different from those seen in the other countries. Conclusions: In this rigorous analysis comparing trends in health inequalities in England both over time and between countries, we could not detect a favourable effect of the English strategy. Our analysis illustrates the usefulness of a modified difference-in-difference approach for assessing the impact of policies on population-level health inequalities.Peer reviewe

Tracking of accelerometry-measured physical activity during childhood: ICAD pooled analysis

Background: Understanding of physical activity (PA) tracking during childhood is important to predict PA behaviors and design appropriate interventions. We compared tracking of PA according to PA level and type of day (weekday/weekend) in a pool of five children's cohort studies.Methods: Data from ALSPAC, CLAN, Iowa Bone Development Study, HEAPS, PEACH were extracted from the International Children's Accelerometry Database (ICAD), resulting in 5,016 participants with age, gender, and accelerometry data at both baseline and follow-up (mean age: 10.3 years at baseline, 12.5 years at follow-up). Daily minutes spent in moderate- and vigorous-intensity PA (MVPA) and vigorous-intensity PA (VPA) was categorized into quintiles. Multinomial logistic regression models were fit to predict follow-up (M)VPA from baseline (M)VPA (reference: 20- < 80%tile), age at follow-up, and follow-up duration.Results: For the weekday, VPA tracking for boys with high baseline VPA was higher than boys with low baseline VPA (ORs: 3.9 [95% CI: 3.1, 5.0] vs. 2.1 [95% CI: 1.6, 2.6]). Among girls, high VPA was less stable when compared low VPA (ORs: 1.8 [95% CI: 1.4, 2.2] vs. 2.6 [95% CI: 2.1, 3.2]). The pattern was similar for MVPA among girls (ORs: 1.6 [95% CI: 1.2, 2.0] vs. 2.8 [95% CI: 2.3, 3.6]). Overall, tracking was lower for the weekend.Conclusions: PA tracking was higher on the weekday than the weekend, and among inactive girls than active girls. The PA " routine" of weekdays should be used to help children establish healthy PA patterns. Supports for PA increase and maintenance of girls are needed. © 2012 Kwon and Janz; licensee BioMed Central Ltd