On the measurement of inequalities in health

This paper offers a critical appraisal of the various methods employed to date to measure inequalities in health. It suggests that only two of these—the slope index of inequality and the concentration index—are likely to present an accurate picture of socioeconomic inequalities in health. The paper also presents several empirical examples to illustrate of the dangers of using other measures such as the range, the Lorenz curve and the index of dissimilarity

Cause-specific inequalities in mortality in Scotland: two decades of change. A population-based study

<p><b>Background:</b> Socioeconomic inequalities in mortality have increased in recent years in many countries. We examined age-, sex-, and cause-specific mortality rates for social groups in and regions of Scotland to understand the patterning of inequalities and the causes contributing to these inequalities.</p> <p><b>Methods:</b> We used death records for 1980–82, 1991–92 and 2000–02 together with mid-year population estimates for 1981, 1991 and 2001 covering the whole of Scotland to calculate directly standardised mortality rates. Deaths and populations were coded to small areas (postcode sectors and data zones), and deprivation was assessed using area based measures (Carstairs scores and the Scottish Index of Multiple Deprivation). We measured inequalities using rate ratios and the Slope Index of Inequality (SII).</p> <p><b>Results:</b> Substantial overall decreases in mortality rates disguised increases for men aged 15–44 and little change for women at the same ages. The pattern at these ages was mostly attributable to increases in suicides and deaths related to the use of alcohol and drugs. Under 65 a 49% fall in the mortality of men in the least deprived areas contrasted with a fall of just 2% in the most deprived. There were substantial increases in the social gradients for most causes of death. Excess male mortality in the Clydeside region was largely confined to more deprived areas, whilst for women in the region mortality was in line with the Scottish experience. Relative inequalities for men and women were greatest between the ages of 30 and 49.</p> <p><b>Conclusion:</b> General reductions in mortality in the major causes of death (ischaemic heart disease, malignant neoplasms) are encouraging; however, such reductions were socially patterned. Relative inequalities in mortality have increased and are greatest among younger adults where deaths related to unfavourable lifestyles call for direct social policies to address poverty.</p&gt

Minority environmental activism in Britain: From brixton to the lake district

Historically, the British environmental movement has been devoid of minority participation, but this is changing very slowly, with the emergence of ethnic minority environmental groups and multiracial environmental alliances. These groups have argued that ethnic minorities have little or no access to public funds earmarked for countryside and wildlife preservation issues. They argue that white environmental organizations do not pay attention to the needs of inner-city minority residents and minority access to the countryside. Increased access, community improvement and beautification projects, environmental education, youth training, community garden projects, and issues of environmental racism are all foci of ethnic minority environmental movements. While some white environmentalists have been supportive of them, others have been uncomfortable with them or even hostile to their existence.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43549/1/11133_2004_Article_BF00990102.pd