Conference Agenda

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Session Overview
RN16_04a: Class, Gender and Ethnic Inequalities
Wednesday, 21/Aug/2019:
6:00pm - 7:30pm

Session Chair: Lia Lombardi, Fondazione ISMU; University of Milan
Location: UP.4.204
University of Manchester Building: University Place, Fourth Floor Oxford Road

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"Socioeconomic Inequalities In Health-related Outcomes Of Green Spaces In The Brussels Capital Region: An Intersectional Approach"

Lucía Rodríguez-Loureiro1, Lidia Casas2,3,4, Christophe Vanroelen1,5, Sylvie Gadeyne1

1Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Belgium; 2Centre for Environment and Health – Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; 3Research Foundation Flanders (FWO), Brussels, Belgium; 4ISGlobal, Barcelona Institute for Global Health, Spain; 5Health Inequalities Research Group (GREDS), Universitat Pompeu Fabra, Barcelona, Spain

Background: The evidence of the relationship between green spaces and self-perceived health is only moderate and the effect of socioeconomic inequalities on this relationship remains unclear. Additionally, an intersectionality approach has never been applied.

Objectives: This study aims to examine the relationship between green spaces and poor self-perceived health in the Brussels Capital Region (BCR), examining whether patterns of association differ according to the intersection between age, gender, socioeconomic status and migrant background.

Methods: Information on socioeconomic indicators, perceived green quality and self-perceived health has been collected from the 2001 Belgian Census. Quantity of green spaces has been obtained from the 2006 CORINE Landcover dataset at the statistical ward level. The study population comprised 682,598 persons. Multilevel logistic regression models at both the statistical ward and the individual level were conducted in order to obtain adjusted odds ratios (aOR) and their confidence intervals (95%CI) of the association between the quantity of green spaces, perceived green quality and poor self-perceived health. Models were first adjusted by air pollution concentrations, age, sex, socioeconomic indicators and migrant background. Interaction and stratification analyses were performed by age groups, gender, socioeconomic status and migrant background.

Results: Quantity of green spaces had no effect on self-perceived health after adjusting by socioeconomic status. Interaction terms were not significant. We found a consistent negative association between good perceived green quality and poor self-perceived health. However, positive and significant interactions were found among lower-educated Moroccans, and no significant association with poor self-perceived health was found in this subgroup after stratifying by migrant background.

Conclusions: The unexpected results could be produced by a specific distribution of spatial inequalities within the BCR.

Gradient Or Threshold? – Health Inequalities In And Around The Poverty Line In Europe

Sakari Karvonen, Pasi Moisio

National Institute for Health and Welfare, Finland

Research on health inequalities shows considerable variation in health by socioeconomic position regardless of measurement. Further, a health gradient seems to frequent in most contexts. However, even though the health measurement has been based on relatively sophisticated indicators, SEP is often measured with rough estimates describing education, income or profession. Hence, the previous analyses have rested on stable and rather crude categorisations that do not allow for more nuanced societal dynamics. One reason for this is that health inequalities research has developed mainly independently of research on stratification and poverty. In research on stratification, poverty is analyzed as a multidimensional and dynamic phenomenon that a large part of population experiences during their life course. Poverty research has a long tradition of developing poverty thresholds. These are usually monetary thresholds that a household would need to have to be able to reach a level of living standards defined as adequate. The poverty threshold is a theoretical cornerstone of the field, however, one undisputed threshold has never been empirically found. Recently research has accumulated on how and why poverty deteriorates health due to long-term stress. Our aim is to reconcile the two research traditions and our hypothesis is that the connection between health and economic resources is not gradual in bottom of income distribution. Using EU-SILC data we test different income concepts, equalization scales and thresholds to find out is there a “Townsendian Point” in the distribution of economic resources below which health problems start to increase rapidly.

Life Style and Health Inequalities

Trude Gjernes

Nord universitet, Norway

Finnmark county in northern Norway has been overrepresented with health problems for many years. Mortality and morbidity rates have been higher compared to the rest of Norway. During the last decades, the situation has improved, however, a significant health difference between this county and the rest of the country remains. Differences also exist within the county. In a Sami inland municipality women live longer than Norwegian women in general and in a coastal municipality with mostly Norwegian inhabitants, males live shorter than Norwegian men in general. In this paper we use a qualitative approach to explore barriers against health improvement in selected municipalities and how inhabitants adapt their everyday life practices to reduce health inequalities We focus on to what degree the population in those parts of the county are concerned about these differences, and what they do to change the situation. The study focuses on medically known risk factors, and on contextual and structural factors, such as material conditions, work conditions and cultural dispositions, that may cause or influence these inequalities. Data come from ethnographic fieldwork in three municipalities and approximately 40-50 interviews with men and women in two age groups. The theoretical framework is influenced by pragmatist approaches to action and interaction and poststructuralism. Preliminary findings suggest that those with the longest life expectancy seem to be most socially integrated, that many informants adapt their life styles to medically known health risks, and that local communities are developing material affordances that may be used for health promotion.

Social Inequalities in Multimorbidity Patterns in Europe: A Latent Class Analysis

Javier Alvarez-Galvez1, Victor Suarez-Lledo2, Juan Luis Gonzalez-Caballero3, Juan Luis Peralta4, Maria Dueñas5, Alejandro Salazar6, Carolina Lagares-Franco7, Jose Almenara-Barrios8

1University of Cadiz, Spain; 2University of Cadiz, Spain; 3University of Cadiz, Spain; 4University of Cadiz, Spain; 5University of Cadiz, Spain; 6University of Cadiz, Spain; 7University of Cadiz, Spain; 8University of Cadiz, Spain

Life expectancy has increased dramatically in all regions of the world over the last years. The average life expectancy in Western Europe was 79 years for males and 84 years for females in 2018. Consequently, the number of people suffering (or at risk of) long-term conditions, such as diabetes, heart disease, musculoskeletal disorders, mental health conditions, or cancer is also rising rapidly. Multimorbidity can be defined as the presence of two or more chronic medical conditions in an individual and is one of the main challenges facing governments and healthcare systems around the world. This health condition is associated with a lower quality of life, increased disability, functional decline, higher healthcare utilization and fragmentation of care, complex treatment, and higher mortality. This study is aimed to identify the underlying determinants of social inequalities in multimorbidity. We used latent class analysis to identify multimorbidity subgroups with interdepended disease patterns using the European Social Survey. The statistical model was based on 13 chronic diseases: heart problem, high blood pressure, breathing problems, allergies, back or neck pain, muscular or joint pain in hand or arm, muscular pain in foot or leg, stomach or digestion related, skin condition, severe headaches, diabetes, cancer, and obesity. Specific multimorbidity classes with singular disease patterns were identified among different socioeconomic groups the in the latent class analysis. The study showed that some disease combinations were more prevalent between different socioeconomic groups, which suggests that tailored public health strategies are needed to address social inequalities in multimorbidity.

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