Understanding How Inequality in the Distribution of Income Affects Health

Research on the determinants of health has almost exclusively focused on the individual but it seems clear we cannot understand or improve patterns of population health without engaging structural determinants at the societal level. This article traces the development of research on income distribution and health to the most recent epidemiologic studies from the USA that show how income inequality is related to age-adjusted mortality within the 50 States. (r 520.62, p 5 0.0001) even after accounting for absolute levels of income. We discuss potential material, psychological, social and behavioral pathways through which income distribution might be linked to health status. Distributional aspects of the economy are important determinants of health and may well provide one of the most pertinent indicators of overall social well-being.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66686/2/10.1177_135910539700200303.pd

Exploring Institutional Research Ethics Systems: A Case Study From Uganda

BACKGROUND: The increasing globalization of research drives a need for greater research ethics capacity in low resource countries. Several programs have attempted to expand research ethics capacity by training individuals, but few have focused on broader research ethics systems and institutions. This study describes and applies an institutional research ethics model to assess the institutional research ethics capacity of Makerere University College of Heath Sciences (MakCHS) in 2011. METHODS: Internal and external stakeholders conducted the assessment of MakCHS using the multidimensional Octagon framework. Five methods were used to collect data on current ethical processes and institutional relationships. RESULTS: MakCHS scored in the mid range on all Octagon domains, with some variation between external and internal assessments. The external Octagon scores suggest that MakCHS’s areas of strengths are in identity, structure, relevance, target groups, and working environment; needs are greater in the areas of production, competence, and systems of finance and administration. Discrepancies in external and internal assessment can serve as a useful platform to shape ongoing discussions and strategic efforts. CONCLUSIONS: The assessment identified strengths, opportunities, and challenges for institutional research ethics capacity at MakCHS. We believe this systematic approach was helpful in evaluating research ethics needs and provides a benchmark for institutions to measure progress over time