Income Inequality and Chronic Health Conditions: A Multilevel Analysis of the U.S. States

Recently, scholarly work has examined the effect of rising income inequality on health outcomes. However, this work is somewhat inconclusive. The mechanisms that could produce such an association are still being sorted out. Much of this work focuses on mortality outcomes with little attention to how this process operates for actual health conditions, including chronic health problems—arguably the main public health concerns of the developed world. In a series of multilevel binary logistic regression models using data from the 2005 and 2007 Behavioral Risk Factor Surveillance System, we examine the association between state-level income inequality, poverty, and social welfare measures on spending and policy to examine the association between these factors for three chronic health outcomes: diabetes, hypertension, and coronary heart disease. We find that income inequality is conditionally positively related only to the diagnosis of diabetes and hypertension, and only in 2007. However, absolute poverty is related to the outcome across all three dependent variables. Certain social welfare measures attenuate the effects of both income inequality and absolute poverty, suggesting that some policies reduce this association.     

The free movement of people around the world would be Utopian: IUAES World Congress 2013: Evolving Humanity,Emerging Worlds, 5–10 August 2013

This article contains the text and discussion of a debate held at the IUAES World Congress in Anthropology at Manchester University in 2013. The motion was proposed by Bela Feldman-Bianco (State University of Campinas), seconded by Noel Salazar (University of Leuven) and was opposed by Shahram Khosravi (Stockholm University), seconded by Nicholas de Genova (then at Goldsmiths’ College). The debate was chaired by Simone Abram (Durham University).     

Evaluation of hip abductor and adductor strength in the elderly: a reliability study

Background

In elderly individuals an increased muscle strength contributes to the diminution of the falls risk and associated adverse events. An increasing interest in lateral control exists due to the fatal consequences of postero-lateral falls. Therefore a proper assessment of frontal plane hip muscle strength in elderly is important but remains challenging.Therefore we aimed to investigate the feasibility and repeatability of a hip abductor and adductor maximum voluntary isometric strength (MVIS) and rate of force generation (RFG) test in elderly. This represents an initial step in the development process of a new and clinically relevant test that could lead to more specific treatment protocols for this population.

Methods

In this measurement focused study hip abduction (ABD) and adduction (ADD) MVIS and RFG were tested twice within one to three hours with a dynamometer fixed to a custom made frame in a geriatric population including fallers and non-fallers. Intraclass correlation coefficient (ICC_agreement), standard error of measurement (SEM), and smallest detectable difference (SDD) were determined.

Results

All recruited persons (N?=?76; mean age (SD) 80.46 (7.05) years old) completed the tests. The average time needed to complete the strength tests was 10.58 min. (1.56) per muscle group. The reliability of the hip ABD and ADD was high with ICC’s_agreement ranging from 0.83 to 0.97. The SDD varied between 18.1 and 81.8% depending on the muscle group and type of strength that was evaluated.

Conclusion

Hip abductor and adductor strength measures in older person are feasible and reliable. However, the significance of moderate changes in these measurements may be limited by the large SDD and SEM. Therefore, physical therapist should be careful when using this measure for assessing the progress of an individual person in a daily clinical use.

     

Models for Extremal Dependence Derived from Skew‐symmetric Families

Skew‐symmetric families of distributions such as the skew‐normal and skew‐t represent supersets of the normal and t distributions, and they exhibit richer classes of extremal behaviour. By defining a non‐stationary skew‐normal process, which allows the easy handling of positive definite, non‐stationary covariance functions, we derive a new family of max‐stable processes – the extremal skew‐t process. This process is a superset of non‐stationary processes that include the stationary extremal‐t processes. We provide the spectral representation and the resulting angular densities of the extremal skew‐t process and illustrate its practical implementation.     

Rural structural change,poverty and income distribution: evidence from Peru

Some rural regions of Peru showed remarkable rates of poverty reduction and inequality reduction between 2004 and 2012, while others lagged behind. Using microsimulation-based decompositions, we analyse the driving forces behind these trends, finding that rural poverty and inequality reductions are mainly attributable to increasing labour incomes in Peru’s agricultural sector and, to a smaller extent, increasing public transfers. In earlier years, higher returns to experience drive these results, while in later years, increasing staple-crop yields and prices are of key importance. Further, remuneration of working hours increases in reaction to labour-supply shortages in rural areas. The accompanying rising incomes and non-agricultural job creation is less pro-poor than would be ideal, as they benefit more highly skilled workers. Further, shrinking farm sizes hampers poverty reduction and income-inequality reduction. Policies should target the participation of the poor in high-value (non-)agricultural activities, especially if positive trends in commodity prices are only transitory.     

Where do IPBES delegates in Europe see challenges,needs, gaps and opportunities in policy uptake of “Nature’s contributions to people”?

This research note illustrates how European national delegates to the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES) perceive the challenges, needs, gaps and opportunities related to the policy implementation of “Nature’s contributions to people (NCP)” in their nation. Until now, only little information has been available on how IPBES delegations perceive national policy-uptake and the implementation of the IPBES core concept of NCP. Based on an online survey with IPBES delegates, we aim to provide a stock-take of how IPBES delegations see NCP currently being incorporated in national government policies in Europe and how these policies are being implemented through programmes. Survey results show IPBES delegates consider a lack of relevant data and methodologies for NCP assessments to be a major obstacle to the uptake and implementation of NCP concepts in Europe. We wonder if availability of data and methodologies are the most prominent challenges to make IPBES a success, and consider the need for policy uptake and implementation to be more prominently addressed within the IPBES process.     

‘Acupuncture for antenatal depression: It’s worth giving it a go’ — A qualitative study

Background

Treatment strategies for the management of antenatal depression are limited by varied and often modest response rates, unpleasant medication side effects and uncertainty regarding foetal safety. Consequently, many pregnant women experiencing depression seek alternative non-pharmaceutical options. Acupuncture may provide a safe and potentially effective additional treatment, however further investigation is required. In this qualitative study, we explored the views of health professionals regarding the possible incorporation of acupuncture into mainstream care.

Women’s experiences of having depression during pregnancy and receiving acupuncture treatment—A qualitative study

Background

Research indicates some women experiencing depression during pregnancy are dissatisfied with conventional depression treatments due to incomplete effectiveness, dislike of side effects, unsatisfactory experiences with providers and concerns regarding in-utero and breastfeeding safety. Consequently, many explore alternative options including acupuncture. To further understand women’s views, preferences and motivations in this regard, as well as their experiences of receiving acupuncture as part of a three-armed pragmatic randomised controlled trial evaluating acupuncture for antenatal depression in Sydney, Australia, in-depth interviews were conducted with a group of acupuncture recipients.