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This study revisits the effect of duration by residence in relation to smoking during pregnancy. It contributes to the literature by incorporating a health inequity perspective, and discusses whether immigrants tend to converge with Swedish women’s smoking. The study is based on Swedish Medical Birth Register and includes 1 1864 52 pregnancies between 1991 and 2012. Logistic regression was performed to attain crude and adjusted Odds Ratios and 95 % confidence intervals. Immigrants’ are divided by categorizing countries of origin depending on levels of Human Development (IHDI). Overall immigrant women show low levels of smoking during pregnancy when they arrive to Sweden, by duration of residence levels of smoking increase and converge with smoking patterns of Swedish women. I found that there are differences in smoking patterns depending on IHDI of the country. Immigrant women of higher categories of IHDI show higher levels of smoking although the increase of smoking is higher among immigrant women from categories of lower IHDI. However, immigrant women’s smoking during pregnancy is affected by duration of residence, and the increased smoking is associated with health inequalities related to their country of origins IHDI, and by socioeconomic inequalities in Sweden.

The impact of Community - on health is one of the core issues of sociology and social epidemiology. Dengue fever, whose occurrence and eradication highly depend in the environment of the community, provides an opportunity to explore the relationship between the community and the health. This study focuses on the outbreak of Dengue fever in 2006 in Kaohsiung City and analyzes how community factors affect the cluster infections of. This study uses the theories of social capital and social vulnerability to explore the effect population, socioeconomic status, and public participation in the community on cluster infection. Social capital is formed by community members through participating in public affairs and voluntary organizations; social vulnerability refers to the overall socio-economic conditions that shape the ability of community to respond to the undesirable events. The social capital index was constructed composed of the Community Development Association, the voting rate of warden elections. Social vulnerability index is based on the compositions of the population, including the proportion of elderly males, population change rate, ratio of low-income households the proportion of dependents than average household income. In addition to consideration the spatial characteristics of dengue fever, this thesis uses Moran's I and LISA test dengue fever outbreaks, and correct the result by Geographically Weighted Regression. The results shows the impact of community factors on the health of residents, provide health sociology and control of dengue fever different reflections direction.

No / This ground-breaking book examines inequalities experienced by LGBT people and considers the role of social work in addressing them. The book is organised in three parts: the first provides a policy context in four countries, the second examines social work practice in tackling health inequalities, and part three considers research and pedagogic developments. The book’s distinctive approach includes international contributions, practice vignettes and key theoretical perspectives in health inequalities, including social determinants of health, minority stress, ecological approaches and human rights. Lesbian, gay, bisexual and trans health inequalities is relevant to social work educators, practitioners and students, alongside an interdisciplinary audience interested in LGBT health inequalities.

Governments, international agencies, and researchers routinely assess health and income inequalities and inequities so as to better communicate the evidence of their levels and trends to both policy-makers and the general public. Measuring the extent to which differences in health or income are unequal or unfair is, however, complex. This thesis contains three chapters centrally concerned with inequalities, though the focus differs across chapters. Chapter 2 helps address the gap between the requirements of indices often used for measuring income-related health inequality and current research practice by providing a non-technical review and critical assessment of the recent literature. This chapter should function as a guide for policy researchers and analysts to help them be more critical consumers of studies that use these indices while also helping applied researchers in choosing inequality measures that have the normative properties they seek. Most measures of inequality make assumptions about the extent to which society is averse to inequality. Moreover, analysts often assume that attitudes toward inequalities in health or income are the same. Chapter 3 is the first study using a mixed-methods approach to assess public attitudes toward inequalities in income, health, and income-related health inequality to determine preferences and how attitudes toward inequalities in these domains differ. Chapter 2 and 3 contribute to a greater understanding of the measurement and interpretation of inequalities. While chapters 2 and 3 focus on inequalities among individuals within a society, chapter 4 focuses on inequalities globally among societies. Chapter 4 examines global health inequalities that result from medical care use using the example of long-standing drug technologies for treating hypertension. The study links availability and affordability of blood-pressure-lowering medicines with individual use and health outcomes. Chapter 4, therefore, provides an empirical illustration on how country-specific policies can play an important role in either countering or exacerbating health differences. / Thesis / Doctor of Philosophy (PhD) / This thesis concerns itself with different aspects of inequality related to health and income, though the focus differs across chapters. The second and third chapters of this thesis contribute to a greater understanding of the measurement and interpretation of inequalities. Whereas the fourth chapter provides empirical evidence on how country-specific policies can counteract or exacerbate health differences. Chapter 2 comprehensively reviews and critically assesses the literature on the technical and normative properties of indices commonly used for measuring income-related health inequality thereby addressing the gap between the requirements of these indices and current research practice. Chapter 3 investigates public attitudes toward inequalities in income, health, and income-related health inequality to determine preferences and where attitudes toward these inequalities differ. Chapter 4 examines global health inequalities that result from medical care use using the example of long-standing drug technologies for treating hypertension and links availability and affordability of medicines with individual use and health outcomes.

Doctor of Philosophy / Department of Geography / Bimal K. Paul / This research set out to better understand the impact of socioeconomic characteristics, environmental risk, and the built environment on health in Mobile County, Alabama. A multilevel statistical analysis was used to identify those characteristics that had the greatest impact on health. The variables determined to be the most significant in defining health in Mobile County were used in the development of a health inequity index (HIQ). The index was used to identify the zip code tabulation areas (ZCTAs) in Mobile County that were likely to exhibit greater health inequality, and as a result, a higher potential for health inequity. In this study, a mailed survey on the built environment and health was conducted to gain a better understanding of the characteristics of individual residences, perceptions of individuals in regards to neighborhood health, citizen activism, and the environmental justice movement. Because there was a low response rate for the mailed surveys, fieldwork with face-to-face interviews was conducted in July, 2009. In conjunction with the survey data, mortality data obtained from the Alabama Department of Public Health was incorporated into the multilevel analysis. Using crude death rate, cause-specific death rate for cancer, and cause-specific death rate for heart disease as dependent variables and factors associated with socioeconomic status, environmental risk, and the built environment as independent variables, multiple linear regression was performed. The results of the multiple linear regression identified factors of socioeconomic status, environmental risk, and the built environment that had the greatest impact on health in Mobile County. Geographically weighted regression was performed to test local model strength by ZCTA in Mobile County. It was determined that the health inequity index developed as a result of the multilevel analysis was a reasonable measure of population health. Calculations of HIQ for each ZCTA in Mobile County helped to identify those ZCTAs most in need of intervention. The ZCTAs with high HIQ values were also those where the built environment was extremely poor, indicating that health is impacted by the places where people live.

This dissertation is based on an ethnographic study of Fetal Alcohol Spectrum Disorders (FASD) and the racial, cultural and political considerations that shape the meaning of diagnosis for Alaska Native individuals and families in Anchorage, Alaska. During the period from August 6, 2010 to through August 5, 2011, I worked with foster families and extended natural families living with and supporting individuals diagnosed with FASD. Documenting the experiences of families in their interactions with clinical, state, tribal and non-profit institutions, I sought to understand how a diagnosis of FASD structures opportunities, outcomes and everyday life experiences across several critical life domains, including health, education, employment, kinship and identity. Family narratives and experiences are highlighted to illustrate the ways in which difference is reproduced in everyday public understanding and clinical practice.

Are health inequalities unjust, and if so, how should we measure and evaluate them? This thesis explores the central moral debates that underlie these sorts of questions about health inequalities, and it argues in support of one particular framework for measuring health inequalities. I begin by shedding light on the questions that need to be asked when attempting to determine which types of health inequalities are unjust. After explaining the complexities of several possible views of health inequity, I use these perspectives to inform my discussion of the debate about whether we ought to measure health inequalities in terms of individuals or groups. I evaluate the key tensions between these two opposing points of view. I then introduce a third possible view, which is Yukiko Asada’s idea that both individual and group-based measures of health inequality leave out important moral information, so it is therefore necessary to include both in order to get a full picture of a population’s health inequality. Next, I respond to objections that the proponents of using either a group or individual measurement of inequality on its own might make to the claim that neither measure is sufficient on its own. Finally, I propose some small changes to Asada’s measurement framework, which I believe will demonstrate why those opposed to her view actually ought to embrace it. I conclude that this approach is a promising solution to some of the difficulties defining health inequities that I have called attention to.

Narrowing the gap in health inequality is vital not only from an equity point of view but also from an economic cost point of view. Small-area level investigations of health inequalities can play an important role in this effort. This research is an attempt to produce evidence of within-province social and health inequality. This cross-sectional, ecological study examines the geographical distribution of life expectancy at birth (LE) and its relationships with two domains of deprivation—material and social—at two time periods (1995-1999 and 2003-2007) across 182 ‘communities.’ The deprivation measures were derived from a set of indices now widely used in Quebec. Five community types assigned to the communities represented relative levels of rurality. A general pattern was observed that material deprivation became more prominent as ‘rurality’ increased. The pattern of social deprivation by rurality was more ‘flat’ where other levels of rurality than the most urban type had similar deprivation scores and rankings. LE was patterned by a relative degree of deprivation but not by rurality per se, though high socioeconomic deprivation tends to be observed in ‘rural areas.’ The gaps in LEs between the most and least deprived were wider for males than for females. Inequalities in LE by material deprivation of the communities appear to have widened over time. The regression models indicated the presence of an interaction effect—material and social deprivation together exacerbate the risk of low LE. The study also observed some regional clustering of unaccounted factors, which requires further investigation to determine what potential regional phenomena account for this effect. Lastly, the deprivation scores left more variations in LE in rural communities unexplained than variations in urban communities, leading us to suspect that the indices employed might be less sensitive for health inequalities in rural communities than in urban communities. Further research efforts are necessary to tackle many questions this research could not address, which would more fully inform policy related to the reduction of health and social inequality in Nova Scotia and elsewhere.

This thesis presents five standalone essays that demonstrate the feasibility and utility of employing advanced analytic techniques to cross-sectional data from Indonesia in order to deal with some technical challenges typically encountered either in the estimation of social gradient in health or in the monitoring and evaluation of well-being as a multidimensional construct. The first essay estimates the causal effect of poverty on mental health by exploiting a natural experiment induced by weather variability across 440 districts in the Indonesian archipelago. The second essay applies parametric anchoring vignette methodology to investigate the extent to which the estimates of demographic and socio-economic inequalities in self-rated health are biased by survey respondents' differential reporting behaviour. The third essay formally assesses the existence and identifies the social determinants of the double burden of malnutrition in Indonesia using a variant of a generalised linear mixed model. The fourth essay maps the social and spatial distributions of malaria in 27 districts in Indonesian Papua using a probabilistic disease mapping technique that is capable of accounting for the complex dependency structure of spatially-correlated multilevel data. The fifth essay examines the extent and patterns of multidimensional poverty in Indonesia over the last decade using a novel poverty measurement method that is sensitive to both the incidence and intensity of multiple deprivations in income, health and education domains. Together, these essays show that although health and social researchers in the developing world have little choice but to conduct cross-sectional studies, new insights can sometimes be gained if one is willing to look at existing data through a new lens. In all five cases presented here, this approach is proved to be useful in shaping practical policy-making.