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Health Inequality and Spatially Distribution

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 26220

Special Issue Editors


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Guest Editor
Department of Public Health, Tzu Chi University, Hualien City 97004, Taiwan
Interests: health policy; health inequality of people with disability; measurement of activity and participation function; health welfare resource distribution; health promotion for people with special needs
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Nature Resources and Environmental Studies, National Dong Hwa, University, Shoufeng, Hualien 974301, Taiwan
Interests: geographic information systems (GIS); statistical analysis of geographic information; community hazard mapping; spatial decision support systems; public health information systems
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Reducing inequality is one of the most important goals of the United Nations for achieving sustainable development, and promoting the health of various population groups in all regions is at its core value. According to the United Nations and UK National Health Insurance, health inequality is an unfair and avoidable difference in people's health between the general population and specific populations.

How national policies can reduce structural factors and promote health equality will be a major challenge for public health in the future. United Nations surveys have shown that in developing countries, children in the poorest 20 per cent of the population are still up to three times more likely to die before their fifth birthday than children in the richest quintiles. Social protection has been significantly extended globally, yet persons with disabilities are up to five times more likely than average to incur catastrophic health expenditures. Despite overall declines in maternal mortality in most developing countries, women in rural areas are still up to three times more likely to die while giving birth than women living in urban centers. The evidence shows that health problems reflected by regional differences have implied socio-economic status, educational level, health resources allocation, and hazardous substances distribution such as behavioral use and pollution spread, of various population groups. If we want to improve health problems through policies, we must first have accurate measurement indicators and empirical data on health inequalities. This topical collection is open to the subject area of health inequality and spatial distribution. The keywords listed below provide an outline of some of the possible areas of interest.

Prof. Chia-Feng Yen
Assoc. Prof. Shyang-Woei Lin
Guest Editors

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Keywords

  • Measuring health inequalities
  • Health inequalities indicators
  • Unequal health
  • Epidemiology
  • Health rights
  • Rural–urban disparity
  • Child health
  • Health of vulnerable groups
  • Spatially distribution
  • Geographic information system (GIS) and health
  • The difference between health and spatial distribution.

Published Papers (8 papers)

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Research

9 pages, 656 KiB  
Article
Exploring Factors Associated with Functional Change and Predictors of Participation Improvement—A Two Years Follow-Up on People with Depression
by Wen-Chou Chi, Chia-Feng Yen, Tsan-Hon Liou, Kwang-Hwa Chang, Hua-Fang Liao and Ya-Li Chang
Int. J. Environ. Res. Public Health 2021, 18(7), 3439; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073439 - 26 Mar 2021
Cited by 2 | Viewed by 1638
Abstract
The purpose of this study is to understand the functional status distribution and to explore the factors associated with changes in functional status and social participation in people with depression using two-year follow-up data. Subjects were selected from the Taiwan Databank of Persons [...] Read more.
The purpose of this study is to understand the functional status distribution and to explore the factors associated with changes in functional status and social participation in people with depression using two-year follow-up data. Subjects were selected from the Taiwan Databank of Persons with Disabilities (TDPD) if they had an evaluation date between July 2012 and 31 December 2017. We used data for 1138 individuals with multiple evaluation records and who were diagnosed with depression. The WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) was the primary functional status measure. Other factors selected from the TDPD included social demographic data, living situation, employment status, economic status, and educational level. The results show scores in all dimensions of the WHODAS 2.0 declined over two years, especially in the domains of cognition, household activities, social participation, and total WHODAS 2.0 score. Aging groups showed poor recovery in cognition, getting along with others, and household activities. People living in suburban areas showed poorer recovery than people living in rural and urban areas in cognition, self-care, and general function (total score of WHODAS 2.0). Employment was also strongly associated with functional recovery in household activities, social participation, and general function. The original scores for cognition and getting along with others showed a significant negative relationship with social participation improvement. Our results can be used by policy makers to provide resources and conduct investigations, and by clinicians when making rehabilitation plans. Full article
(This article belongs to the Special Issue Health Inequality and Spatially Distribution)
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9 pages, 319 KiB  
Article
Predictors of Use of Preventative Health Services for People with Disabilities in Taiwan
by Tzu-Ying Chiu
Int. J. Environ. Res. Public Health 2021, 18(4), 1661; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041661 - 09 Feb 2021
Cited by 1 | Viewed by 2453
Abstract
People with disabilities display less use of preventive health services, such as health examinations, flu vaccinations, Pap smears and breast screening, but evidence has shown that preventive health services can detect or even prevent serious diseases and medical problems. Therefore, identifying the factors [...] Read more.
People with disabilities display less use of preventive health services, such as health examinations, flu vaccinations, Pap smears and breast screening, but evidence has shown that preventive health services can detect or even prevent serious diseases and medical problems. Therefore, identifying the factors associated with the use of preventive health services is important for people with disabilities. This study examined the use of preventive health services by people with disabilities and identified other associated factors for people with disabilities. The research used social demographics and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 12 items to measure activity and participation (AP) and other factors; there were 742 people with disabilities recruited with stratified proportional sampling. The data were collected through face-to-face interviews. The findings revealed that the common types of preventive services accessed by people with disabilities were health examinations and flu vaccinations; most of them had only used one preventive health service in the past year. The factors of having caregivers of spouses (OR = 1.74), perceived good health (OR = 1.26), and less limitation of AP (OR = 0.99) were significantly associated with the use of preventive services (p < 0.01). The study found a significant association between having children as caregivers and the non-use of Pap smears and breast screening services among women, providing valuable evidence for the distribution of the use of preventive health services for people with disabilities. Furthermore, the study highlighted the present status of disparities in the use of preventive services for people with disabilities and should encourage a boost in the adjustment of the medical environment and service resource allocation by the Taiwanese government for people with disabilities. Full article
(This article belongs to the Special Issue Health Inequality and Spatially Distribution)
21 pages, 606 KiB  
Article
A Multilevel Perspective on the Health Effect of Social Capital: Evidence for the Relative Importance of Individual Social Capital over Neighborhood Social Capital
by Susan Lagaert, Thom Snaphaan, Veerle Vyncke, Wim Hardyns, Lieven J. R. Pauwels and Sara Willems
Int. J. Environ. Res. Public Health 2021, 18(4), 1526; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041526 - 05 Feb 2021
Cited by 9 | Viewed by 3728
Abstract
Employing a multilevel perspective on the health effects of social capital, this study analyzes how individual and neighborhood differences in self-rated health in Ghent (Belgium), relate to individual and collective social mechanisms, when taking demographic and socioeconomic characteristics of individuals into account. This [...] Read more.
Employing a multilevel perspective on the health effects of social capital, this study analyzes how individual and neighborhood differences in self-rated health in Ghent (Belgium), relate to individual and collective social mechanisms, when taking demographic and socioeconomic characteristics of individuals into account. This study estimates the health effects of social trust, informal social control and disorder at the neighborhood level and social support and network size at the individual level, using indicators indebted to both the normative and resource-based approaches to social capital. Instead of the mere aggregation of individual indicators of social capital, this study uses the key informant technique as a methodologically superior measurement of neighborhood social capital, which combined with a multilevel analysis strategy, allows to disentangle the health effects of individual and neighborhood social capital. The analysis highlights the health benefits of individual social capital, i.e., individual social support and network size. The study indicates that controlling for individual demographic and socioeconomic characteristics reduces the effect of the neighborhood-level counterparts and the neighborhood characteristics social trust and neighborhood disorder have significant, but small health effects. In its effects on self-rated health, social capital operates on the individual level, rather than the neighborhood level. Full article
(This article belongs to the Special Issue Health Inequality and Spatially Distribution)
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14 pages, 1421 KiB  
Article
The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan
by Shyang-Woei Lin, Tzu-Ying Chiu, Tsan-Hon Liou, Chia-Feng Yen and Hui-Guan Chen
Int. J. Environ. Res. Public Health 2020, 17(20), 7553; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207553 - 17 Oct 2020
Cited by 4 | Viewed by 1873
Abstract
Developmental disability is likely to be lifelong in nature and to result in substantial activity and societal participation limitations. The performance of individuals is related to the environment, supports, and urbanization of living cities. Most of the surveys for people with disabilities have [...] Read more.
Developmental disability is likely to be lifelong in nature and to result in substantial activity and societal participation limitations. The performance of individuals is related to the environment, supports, and urbanization of living cities. Most of the surveys for people with disabilities have not discussed the relationship between the cognitive impairment properties and performance of participation and activities functioning, and most cognitive impairments are regarded as having similar performance. The location of residence in childhood is mainly influenced by parents and main caregivers, but the factors related to the preferences of adults with cognitive impairment in the location of residence are more complicated. Objective(s): The aim was to explore and compare the relationships of the urbanization degree of their living cities and the functioning performance of daily living in various domains among adults with intellectual disability (ID), autism, and concomitant communicative impairment (CCI). Method: The cross-sectional study was applied, and the data was collected face-to-face by professionals in all authorized hospitals in Taiwan. The participants were 5374 adults with ID (n = 4455), autism (n = 670), CCI (n = 110) and combination disabilities (n = 139) which were according to the International Statistical Classification of Diseases 9th Revision (ICD-9) from a total of 167,069 adults with disabilities from the Disability Eligibility System (DES) in Taiwan between July 2012 and October 2013. The authors used the World Health Organization Disability Assessment Schedule 2.0–36 item version of WHO (WHODAS 2.0-36 items) to measure performance and capability of daily living. Results and Conclusions: There were significant differences in age, gender, disabled severity, and the urbanization between all subgroups (p < 0.05). After adjusting the age of all participators, the degree of urbanization just significantly affected the functioning score distribution in domain 1: cognition for an adult with ID, autism, and CCI; in domain 2, mobility for an adult with CCI and combination disability; in domain 3, self-care; domain 4, independent domains for ID (p < 0.05). There were no significant differences between urbanization degree and functioning scores in all domains for adults with autism. All in all, only in groups with combination disability did we find that the worse the degree of impairment was, the lower the degree of urbanization of their place of residence was, and there was no such phenomenon in adults with autism and ID in our study. Full article
(This article belongs to the Special Issue Health Inequality and Spatially Distribution)
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14 pages, 1283 KiB  
Article
The Association between Noise Exposure and Metabolic Syndrome: A Longitudinal Cohort Study in Taiwan
by Tao Huang, Ta-Chien Chan, Ying-Jhen Huang and Wen-Chi Pan
Int. J. Environ. Res. Public Health 2020, 17(12), 4236; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124236 - 14 Jun 2020
Cited by 23 | Viewed by 3720
Abstract
Metabolic syndrome is becoming more common worldwide. Studies suggest environmental pollution, including traffic noise, might be linked with metabolic syndrome. This study sought to evaluate how noise exposure is linked to the development of metabolic syndrome and its components in Taiwan. Using data [...] Read more.
Metabolic syndrome is becoming more common worldwide. Studies suggest environmental pollution, including traffic noise, might be linked with metabolic syndrome. This study sought to evaluate how noise exposure is linked to the development of metabolic syndrome and its components in Taiwan. Using data from a cohort of 42,509 participants and Cox proportional hazards regression models, the effects of noise exposure on metabolic syndrome and its components were quantified. After adjustment for covariates (age, gender, body mass index, and physical activity), the hazard ratio for metabolic syndrome was 1.13 (95% CI: 1.04–1.22) for medium noise exposure and 1.24 (95% CI: 1.13–1.36) for high noise exposure. Noise exposure was also positively associated with all of metabolic syndrome’s components. This finding suggests noise exposure might contribute to metabolic syndrome and its components. Policies aiming to reduce noise pollution might reduce the risks of metabolic syndrome and its components. Full article
(This article belongs to the Special Issue Health Inequality and Spatially Distribution)
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26 pages, 2911 KiB  
Article
Gender Inequalities in Health and Their Effect on the Economic Prosperity Represented by the GDP of Selected Developed Countries—Empirical Study
by Robert Stefko, Beata Gavurova, Viera Ivankova and Martin Rigelsky
Int. J. Environ. Res. Public Health 2020, 17(10), 3555; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103555 - 19 May 2020
Cited by 15 | Viewed by 4130
Abstract
The objective is to evaluate the relations between gender health inequalities and economic prosperity in the Organisation for Economic Co-operation and Development (OECD) countries. The groups included health indicators in the specification of men, women and gender inequalities: life expectancy, causes of mortality [...] Read more.
The objective is to evaluate the relations between gender health inequalities and economic prosperity in the Organisation for Economic Co-operation and Development (OECD) countries. The groups included health indicators in the specification of men, women and gender inequalities: life expectancy, causes of mortality and avoidable mortality. The variable determining the economic prosperity was represented by the Gross Domestic Product (GDP). The analytical processing included descriptive analysis, analysis of differences and analysis of relationships. The regression analysis was presented as the main output of the research. Most of the significant gender differences in health showed a more positive outcome for women. It is possible to identify a certain relation between gender health inequalities and economic prosperity. If there is some reduction in gender inequalities in health, the economic prosperity will increase. The reduction seems to be more effective on the part of men than women. The output of the cluster analysis showed the relations of indicators evaluating the inequalities and the prosperity. The countries such as Luxembourg, Norway or Switzerland showed very positive outputs, on the other hand, the countries with a potential for the improvement are Lithuania, Latvia or Estonia. Overall, the policies should focus on reducing the inequalities in avoidable mortality as well as reducing the frequent diseases in younger people. Full article
(This article belongs to the Special Issue Health Inequality and Spatially Distribution)
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16 pages, 2138 KiB  
Article
Association between Cardiovascular Mortality and Economic Development: A Spatio-Temporal Study for Prefectures in Japan
by Emerson Augusto Baptista, Kaoru Kakinuma and Bernardo Lanza Queiroz
Int. J. Environ. Res. Public Health 2020, 17(4), 1311; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17041311 - 18 Feb 2020
Cited by 10 | Viewed by 3744
Abstract
In this paper, we use a bivariate choropleth map to investigate the relationship between mortality from cardiovascular disease (CVD) and gross domestic product (GDP) per capita, by sex, in Japanese prefectures from 1996 to 2015. The overall results show a decline in age-standardized [...] Read more.
In this paper, we use a bivariate choropleth map to investigate the relationship between mortality from cardiovascular disease (CVD) and gross domestic product (GDP) per capita, by sex, in Japanese prefectures from 1996 to 2015. The overall results show a decline in age-standardized CVD mortality rates in all prefectures, for both men and women, and suggest that GDP per capita has varied over the period. We also observed that the relationship between CVD mortality rates and GDP per capita at the prefecture level does not have an overall pattern of the same or inverse association, but is instead a heterogeneous relationship. We argue that this study provides useful clues to policy makers for establishing effective measures for public health planning and the prevention of deaths from CVD. As demonstrated by this study, mapping of the CVD burden in Japan helps to clarify regional differences in life expectancy and health status across regions and identify prefectures where more targeted policy attention may be needed. Full article
(This article belongs to the Special Issue Health Inequality and Spatially Distribution)
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18 pages, 1622 KiB  
Article
Measuring Health Vulnerability: An Interdisciplinary Indicator Applied to Mainland Portugal
by Gisela M. Oliveira, Diogo Guedes Vidal, Maria Pia Ferraz, José Manuel Cabeda, Manuela Pontes, Rui Leandro Maia, José Manuel Calheiros and Esmeralda Barreira
Int. J. Environ. Res. Public Health 2019, 16(21), 4121; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16214121 - 25 Oct 2019
Cited by 9 | Viewed by 3892
Abstract
Health promotion and inequality reduction are specific goals of the United Nations 2030 Agenda, which are interconnected with several dimensions of life. This work proposes a composite index SEHVI—socioeconomic health vulnerability index—to address Portuguese population socioeconomic determinants that affect health outcomes. Variables [...] Read more.
Health promotion and inequality reduction are specific goals of the United Nations 2030 Agenda, which are interconnected with several dimensions of life. This work proposes a composite index SEHVI—socioeconomic health vulnerability index—to address Portuguese population socioeconomic determinants that affect health outcomes. Variables composing SEHVI are aligned with the sustainable development goals considering data and times series availability to enable progress monitoring, and variables adequacy to translate populations’ life conditions affecting health outcomes. Data for 35 variables and three periods were collected from official national databases. All variables are part of one of the groups: Health determinants (social, economic, cultural, and environmental factors) and health outcomes (mortality indicators). Variables were standardized and normalized by “Distance to a reference” method and then aggregated into the SEHVI formula. Several statistical procedures for validation of SEHVI revealed the internal consistency of the index. For all municipalities, SEHVI was calculated and cartographically represented. Results were analyzed by statistical tests and compared for three years and territory typologies. SEHVI differences were found as a function of population density, suggesting inequalities of communities’ life conditions and in vulnerability to health. Full article
(This article belongs to the Special Issue Health Inequality and Spatially Distribution)
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