inequality

Abstract: Socioeconomic and health-related data at the county level are now available through the Community Health Status Indicators (CHSI) database. These data are useful for assessing the health of communities and regions. Users of the CHSI data can access online reports and an online mapping application for visualizing patterns in various community-related measures. It also is possible to download these data to conduct local analyses. This paper describes a spatial analysis of poverty in the United States at the county level for 2000. Spatial statistical techniques in a geographic information system were used to quantify significant spatial patterns, such as concentrated poverty rates and spatial outliers. The analysis revealed significant and stark patterns of poverty. A distinctive north–south demarcation of low versus high poverty concentrations was found, along with isolated pockets of high and low poverty within areas in which the predominant poverty rates were opposite. This pattern can be described as following a continental poverty divide. These insights can be useful in explicating the underlying processes involved in forming such spatial patterns that result in concentrated wealth and poverty. The spatial analytic techniques are broadly applicable to socioeconomic and health-related data and can provide important information about the spatial structure of datasets, which is important for choosing appropriate analysis methods.

 Geography;  USA;  health;  inequality;  poverty;  

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Abstract: Introduction Social, cultural, and economic environments are associated with high rates of disease incidence and mortality in poor Appalachian regions of the United States. Although many historical studies suggest that aspects of Appalachian culture (e.g., fatalism, patriarchy) include values and beliefs that may put Appalachians at risk for poor health, other cultural aspects may be protective (e.g., strong social ties). Few recent studies have explored regional cultural issues qualitatively. The purpose of this study was to examine social and cultural factors that may be associated with health and illness in an Appalachian region. Methods Ten focus groups were conducted in southern West Virginia and included five groups of men and five groups of women. Cultural norms associated with residents of rural Appalachia, such as faith, family values, and patriarchy, were examined. Results Both men and women in the focus groups have a sense of place, strong family ties, and a strong spiritual belief or faith in God. Patriarchy as a cultural value was not a strong factor. Conclusion There are limits to how qualitative data may be used, but findings from this study help increase understanding of the social and cultural environments of people living in rural Appalachia and how these environments may affect health.

 Geography;  USA;  health;  inequality;  poverty;  appalachia;  

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Abstract: Sorry no abstract available for this article

 Geography;  health;  inequality;  poverty;  appalachia;  

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Abstract: Sorry no abstract available for this article

 health;  editorial;  inequality;  poverty;  appalachia;  

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Abstract: Objective The objective of this study was to examine the association between inadequate functional health literacy in Spanish among low-income Latinas aged 40 and older and cervical cancer screening knowledge and behavior. Methods Spanish-speaking Latinas aged 40–78 of various nationalities (n = 205) participated in a study that included a survey on cervical cancer knowledge and behavior administered in Spanish and the Spanish version of the Test of Functional Health Literacy in Adults. Results Compared to those with adequate and marginal health literacy, women with inadequate functional health literacy in Spanish were significantly less likely to have ever had a Papanicolaou (Pap) test (odds ratio, 0.12; 95% confidence interval [CI], 0.04-0.37) or in the last three years (odds ratio, 0.35; 95% CI, 0.18-0.68) and were significantly more likely to have had their last Pap test at a local public hospital (odds ratio, 2.43; 95% CI, 1.18-4.97). Even when controlling for other factors, women with inadequate health literacy were 16.7 times less likely (adjusted odds ratio, 0.06; 95% CI, 0.01-0.55) to have ever had a Pap test. Conclusion Almost half of the population we studied will have difficulty interpreting written medical materials, even in Spanish. When developing efforts to reach women who have not been screened, programs and service providers need to be aware that the women most in need of information about screening may be more likely to be unable to read any written materials provided to them, regardless of the language or level of simplicity of the materials. Programs and strategies need to be implemented to increase screening prevalence and to minimize the identified gaps in regular screening for Latinas who have low health literacy.

 cancer;  cervical;  immigrant;  inequality;  poverty;  

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Abstract: The literature on equity in health care delivery agrees that adjusting for “medical need” is a necessary component in assessing whether the delivery of care is equitable, that is, whether it varies with ability to pay. To date, most studies measuring income-related inequality in the delivery of health care have employed crude measures of health status to adjust for medical need and have acknowledged this as a limitation. This study examines how using more complete health status measures affects estimates of income-related inequality for U.S. adults. The findings suggest that previous studies may understate the extent of pro-rich inequality.

 health;  inequality;  access;  income;  

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