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Background: Over time, global health systems have witnessed significant improvements in the delivery and coverage of healthcare services. Nevertheless, the increasing prominence of non-communicable diseases remains a persistent challenge. Diabetes is one such non-communicable chronic disease that poses a threat with respect to both mortality and morbidity. This study investigated the socio-economic determinants and inequalities in the prevalence of diabetes in the Kingdom of Saudi Arabia according to data collected from the 2018 Saudi Family Health Survey conducted by the General Authority for Statistics. Methods: The analysis was limited to a sample of 11,528 respondents aged ≥ 18 years, selected across all 13 regions of Saudi Arabia, with complete responses for all variables of interest. Socio-economic determinants in diabetes prevalence were explored with univariate, bivariate, and multivariate logistic regression analyses. Furthermore, inequalities were visualised and quantitatively estimated according to construction of a concentration curve and calculation of the concentration index. Results: The prevalence of diabetes among the 11,528 respondents was 11.20%. Age, education, income, and residence area were significant determinants of diabetes prevalence, with a greater risk of diabetes found in older participants (odds ratio [OR]: 12.262, 95% confidence interval [CI]: 9.820–15.313, p < 0.01) compared to younger participants. Inequality analysis showed a negative education-based concentration index (–0.235, p < 0.01), indicating that diabetes prevalence is concentrated among people with relatively less formal education. For males, the income-based concentration index was significantly positive, whereas the education-based concentration index was significantly negative, indicating a greater concentration of diabetes among Saudi men with higher incomes and less education. Conclusion: These findings emphasize the need to prioritize policies and strategies for diabetes prevention and control with considerations of the socio-economic inequalities in prevalence. Key areas of focus should include improving education levels across all regions, raising awareness about diabetes and implementing nutritional interventions. [ABSTRACT FROM AUTHOR]

Abstract Background Over time, global health systems have witnessed significant improvements in the delivery and coverage of healthcare services. Nevertheless, the increasing prominence of non-communicable diseases remains a persistent challenge. Diabetes is one such non-communicable chronic disease that poses a threat with respect to both mortality and morbidity. This study investigated the socio-economic determinants and inequalities in the prevalence of diabetes in the Kingdom of Saudi Arabia according to data collected from the 2018 Saudi Family Health Survey conducted by the General Authority for Statistics. Methods The analysis was limited to a sample of 11,528 respondents aged ≥ 18 years, selected across all 13 regions of Saudi Arabia, with complete responses for all variables of interest. Socio-economic determinants in diabetes prevalence were explored with univariate, bivariate, and multivariate logistic regression analyses. Furthermore, inequalities were visualised and quantitatively estimated according to construction of a concentration curve and calculation of the concentration index. Results The prevalence of diabetes among the 11,528 respondents was 11.20%. Age, education, income, and residence area were significant determinants of diabetes prevalence, with a greater risk of diabetes found in older participants (odds ratio [OR]: 12.262, 95% confidence interval [CI]: 9.820–15.313, p < 0.01) compared to younger participants. Inequality analysis showed a negative education-based concentration index (–0.235, p < 0.01), indicating that diabetes prevalence is concentrated among people with relatively less formal education. For males, the income-based concentration index was significantly positive, whereas the education-based concentration index was significantly negative, indicating a greater concentration of diabetes among Saudi men with higher incomes and less education. Conclusion These findings emphasize the need to prioritize policies and strategies for diabetes prevention and control with considerations of the socio-economic inequalities in prevalence. Key areas of focus should include improving education levels across all regions, raising awareness about diabetes and implementing nutritional interventions.

Abstract In this research, I examined the role of socioeconomic variations in the prevalence of stunting and underweight among children in Ethiopia. The study aimed to identify key health factors contributing to these disparities in child malnutrition by utilizing concentration indices, concentration curves, and regression-based decomposition analysis. Despite a notable decline in the average rates of stunting and underweight prevalence, the relative and absolute gaps between different demographic and socioeconomic groups have widened in Ethiopia. The empirical analysis revealed that higher levels of maternal education and household wealth significantly benefited children from better socioeconomic backgrounds, making them less likely to experience malnutrition. The disparity in socioeconomic status is the primary driver of inequalities in child malnutrition. The findings suggest that to reduce these disparities, national health policies should focus on promoting maternal literacy and targeting interventions for underprivileged groups.

In this research, I examined the role of socioeconomic variations in the prevalence of stunting and underweight among children in Ethiopia. The study aimed to identify key health factors contributing to these disparities in child malnutrition by utilizing concentration indices, concentration curves, and regression-based decomposition analysis. Despite a notable decline in the average rates of stunting and underweight prevalence, the relative and absolute gaps between different demographic and socioeconomic groups have widened in Ethiopia. The empirical analysis revealed that higher levels of maternal education and household wealth significantly benefited children from better socioeconomic backgrounds, making them less likely to experience malnutrition. The disparity in socioeconomic status is the primary driver of inequalities in child malnutrition. The findings suggest that to reduce these disparities, national health policies should focus on promoting maternal literacy and targeting interventions for underprivileged groups. Key messages: Children from higher socioeconomic backgrounds and mothers' educational levels were less likely to suffer from malnutrition. The disparity in socioeconomic positions is the major cause behind child malnutrition inequities. [ABSTRACT FROM AUTHOR]

BackgroundAddressing health inequity is a top priority for achieving sustainable development goals. The existing evidences in Ethiopia have shown that there are substantial inequalities in the use of health services among various socioeconomic strata. Therefore, the present study aimed to measure socioeconomic inequalities and the contributing factors in postnatal health checks for newborns in Ethiopia.MethodsWe used a secondary data from the recent 2019 Ethiopia Mini Demographic and Health Survey dataset. The study includes a weighted sample of 2,105 women who gave birth in the 2 years preceding to the survey. The study participants were selected using two stage cluster sampling techniques. The socioeconomic inequality in postnatal health checks for newborns was measured using the Erreygers Normalized Concentration Index (ECI) and illustrated by the concentration curve. A decomposition analysis was done to identify factors contributing to the socioeconomic related inequality in postnatal health checks for newborns in Ethiopia.ResultsThe concentration curve of postnatal health checks for newborns lay below the line of equality, and the Erreygers normalized concentration index was 0.133, with a standard error = 0.0333, and a p value

Wüthrich (Eur Actuar J, https://doi.org/10.1007/s13385-022-00339-9, 2023) established that the Gini index is a consistent scoring rule in the class of autocalibrated predictors. This note further explores performances criteria in this class. Elementary Pearson's correlation turns out to be consistent when restricted to autocalibrated predictors. Also, any performance measure that is minimized for predictors that are comonotonic with the true regression model is consistent under autocalibration. This provides a new proof of the consistency for Gini index. In addition, it is established that the concentration curve of the true model is the lowest possible concentration curve under autocalibration and that the same property holds true for Lorenz curve. [ABSTRACT FROM AUTHOR]

The Gini index does not give a strictly consistent scoring function. Therefore, simply maximizing the Gini index may lead to a wrong model choice. The main issue is that the Gini index is a rank-based score that is not calibration-sensitive. We show that the Gini index allows for strictly consistent scoring if we restrict it to the class of auto-calibrated regression models. That is, on the class of auto-calibrated models we know that the true model maximizes the Gini index. [ABSTRACT FROM AUTHOR]

Abstract Background Despite the high rate of teenage pregnancy in Nigeria and host of negative medical, social and economic consequences that are associated with the problem, relatively few studies have examined socioeconomic inequality in teenage pregnancy. Understanding the key factors associated with socioeconomic inequality in teenage pregnancy is essential in designing effective policies for teenage pregnancy reduction. This study focuses on measuring inequality and identifying factors explaining socioeconomic inequality in teenage pregnancy in Nigeria. Methods This is a cross sectional study using individual recode (data) file from the 2018 Nigeria Demographic Health Survey. The dataset comprises a representative sample of 8,423 women of reproductive age 15 – 19 years in Nigeria. The normalized Concentration index (Cn) was used to determine the magnitude of inequalities in teenage pregnancy. The Cn was decomposed to determine the contribution of explanatory factors to socioeconomic inequalities in teenage pregnancy in Nigeria. Results The negative value of the Cn (-0.354; 95% confidence interval [CI] = -0.400 to -0.308) suggests that pregnancy is more concentrated among the poor teenagers. The decomposition analysis identified marital status, wealth index of households, exposure to information and communication technology, and religion as the most important predictors contributing to observed concentration of teenage pregnancy in Nigeria. Conclusion There is a need for targeted intervention to reduce teenage pregnancy among low socioeconomic status women in Nigeria. The intervention should break the intergenerational cycle of low socioeconomic status that make teenagers’ susceptible to unintended pregnancy. Economic empowerment is recommended, as empowered girls are better prepared to handle reproductive health issues. Moreover, religious bodies, parents and schools should provide counselling, and guidance that will promote positive reproductive and sexual health behaviours to teenagers.

Abstract Background Inequality in maternal healthcare use is a major concern for low-and middle-income countries (LMICs). Maternal health indicators at the national level have markedly improved in the last couple of decades in Nepal. However, the progress is not uniform across different population sub-groups. This study aims to identify the determinants of institutional delivery, measure wealth-related inequality, and examine the key components that explain the inequality. Methods Most recent nationally representative Multiple Indicator Cluster Survey (MICS) 2019 was used to extract data about married women (15-49 years) with a live birth within two years preceding the survey. Logistic regression models were employed to assess the association of independent variables with the institutional delivery. The concentration curve (CC) and concentration index (CIX) were used to analyze the inequality in institutional delivery. Wealth index scores were used as a socio-economic variable to rank households. Decomposition was performed to identify the determinants that explain socio-economic inequality. Results The socio-economic status of households to which women belong was a significant predictor of institutional delivery, along with age, parity, four or more ANC visits, education status of women, area of residence, sex of household head, religious belief, and province. The concentration curve was below the line of equality and the relative concentration index (CIX) was 0.097 (p

Background Hypertension remains a problem of public health across various socioeconomic groups, despite its high prevalence. However, few studies account for geographical variation in examining socioeconomic inequalities and hypertension in Indonesia. Objective To investigate the burden of hypertension in Indonesia based on prevalence, awareness, treatment, and control of hypertension among adults; and assess whether or not the burdens vary according to geographical variation and socioeconomic status Methods In Wave 5 of the Indonesian Family Life Survey in 2015, 32,034 individuals aged 15 and over participated in the study. Concentration Curves (CC) and Concentration Indexes (CI) were used to analyse socioeconomic inequality. We used multilevel logistic regression to assess biological, geographical variation, and socioeconomic factors associated with the burden of hypertension, adjusting for potential covariates. Results The prevalence of hypertension in Indonesia was 26.1%, and only 26.9% of those with hypertension were aware of their condition. Approximately 22.5% of hypertensive patients received treatment, but only 28.2% had controlled blood pressure and reached the therapeutic goal. Low socioeconomic groups were more prone to hypertension (CI = −0.047 in urban and CI = −0.075 in rural). In contrast, awareness, treatment, and control of hypertension were more concentrated in higher socioeconomic groups. Conclusions The high prevalence of hypertension, low awareness of the condition, poor compliance with treatment, and poor control of the condition, as well as the existing socioeconomic inequality, make this a significant determinant of public health issue in Indonesia. There is a need for effective programs for the prevention of hypertension and better management of hypertensive patients.

Abstract Background The coronavirus disease 2019 (COVID-19) has resulted in an enormous dislocation of society especially in South Africa. The South African government has imposed a number of measures aimed at controlling the pandemic, chief being a nationwide lockdown. This has resulted in income loss for individuals and firms, with vulnerable populations (low earners, those in informal and precarious employment, etc.) more likely to be adversely affected through job losses and the resulting income loss. Income loss will likely result in reduced ability to access healthcare and a nutritious diet, thus adversely affecting health outcomes. Given the foregoing, we hypothesize that the economic dislocation caused by the coronavirus will disproportionately affect the health of the poor. Methods Using the fifth wave of the National Income Dynamics Study (NIDS) dataset conducted in 2017 and the first wave of the NIDS-Coronavirus Rapid Mobile Survey (NIDS-CRAM) dataset conducted in May/June 2020, this paper estimated income-related health inequalities in South Africa before and during the COVID-19 pandemic. Health was a dichotomized self-assessed health measure, with fair and poor health categorized as “poor” health, while excellent, very good and good health were categorized as “better” health. Household per capita income was used as the ranking variable. Concentration curves and indices were used to depict the income-related health inequalities. Furthermore, we decomposed the COVID-19 era income-related health inequality in order to ascertain the significant predictors of such inequality. Results The results indicate that poor health was pro-poor in the pre-COVID-19 and COVID-19 periods, with the latter six times the value of the former. Being African (relative to white), per capita household income and household experience of hunger significantly predicted income-related health inequalities in the COVID-19 era (contributing 130%, 46% and 9% respectively to the inequalities), while being in paid employment had a nontrivial but statistically insignificant contribution (13%) to health inequality. Conclusions Given the significance and magnitude of race, hunger, income and employment in determining socioeconomic inequalities in poor health, addressing racial disparities and hunger, income inequality and unemployment will likely mitigate income-related health inequalities in South Africa during the COVID-19 pandemic.

Hypertension remains a problem of public health across various socioeconomic groups, despite its high prevalence. However, few studies account for geographical variation in examining socioeconomic inequalities and hypertension in Indonesia. To investigate the burden of hypertension in Indonesia based on prevalence, awareness, treatment, and control of hypertension among adults; and assess whether or not the burdens vary according to geographical variation and socioeconomic status In Wave 5 of the Indonesian Family Life Survey in 2015, 32,034 individuals aged 15 and over participated in the study. Concentration Curves (CC) and Concentration Indexes (CI) were used to analyse socioeconomic inequality. We used multilevel logistic regression to assess biological, geographical variation, and socioeconomic factors associated with the burden of hypertension, adjusting for potential covariates. The prevalence of hypertension in Indonesia was 26.1%, and only 26.9% of those with hypertension were aware of their condition. Approximately 22.5% of hypertensive patients received treatment, but only 28.2% had controlled blood pressure and reached the therapeutic goal. Low socioeconomic groups were more prone to hypertension (CI = −0.047 in urban and CI = −0.075 in rural). In contrast, awareness, treatment, and control of hypertension were more concentrated in higher socioeconomic groups. The high prevalence of hypertension, low awareness of the condition, poor compliance with treatment, and poor control of the condition, as well as the existing socioeconomic inequality, make this a significant determinant of public health issue in Indonesia. There is a need for effective programs for the prevention of hypertension and better management of hypertensive patients. [ABSTRACT FROM AUTHOR]

Background: Inequality in maternal healthcare use is a major concern for low-and middle-income countries (LMICs). Maternal health indicators at the national level have markedly improved in the last couple of decades in Nepal. However, the progress is not uniform across different population sub-groups. This study aims to identify the determinants of institutional delivery, measure wealth-related inequality, and examine the key components that explain the inequality.Methods: Most recent nationally representative Multiple Indicator Cluster Survey (MICS) 2019 was used to extract data about married women (15-49 years) with a live birth within two years preceding the survey. Logistic regression models were employed to assess the association of independent variables with the institutional delivery. The concentration curve (CC) and concentration index (CIX) were used to analyze the inequality in institutional delivery. Wealth index scores were used as a socio-economic variable to rank households. Decomposition was performed to identify the determinants that explain socio-economic inequality.Results: The socio-economic status of households to which women belong was a significant predictor of institutional delivery, along with age, parity, four or more ANC visits, education status of women, area of residence, sex of household head, religious belief, and province. The concentration curve was below the line of equality and the relative concentration index (CIX) was 0.097 (p < 0.001), meaning the institutional delivery was disproportionately higher among women from wealthy groups. The decomposition analysis showed the following variables as the most significant contributor to the inequality: wealth status of women (53.20%), education of women (17.02%), residence (8.64%) and ANC visit (6.84%).Conclusions: To reduce the existing socio-economic inequality in institutional delivery, health policies and strategies should focus more on poorest and poor quintiles of the population. The strategies should also focus on raising the education level of women especially from the rural and relatively backward province (Province 2). Increasing antenatal care (ANC) coverage through outreach campaigns is likely to increase facility-based delivery and decrease inequality. Monitoring of healthcare indicators at different sub-population levels (for example wealth, residence, province) is key to ensure equitable improvement in health status and achieve universal health coverage (UHC). [ABSTRACT FROM AUTHOR]

Abstract Background Short birth interval, defined as a birth-to-birth interval less than 33 months, is associated with adverse maternal and child outcomes. Evidence regarding the association of maternal socioeconomic status and short birth interval is inconclusive. Factors contributing to the socioeconomic inequality of short birth interval have also not been investigated. The current study assessed socioeconomic inequality in short birth interval and its contributing factors in Ethiopia. Methods Data from 8448 women collected in the 2016 Ethiopia Demographic and Health survey were included in the study. Socioeconomic inequality in short birth interval was the outcome variable. Erreygers normalized concentration index (ECI) and concentration curves were used to measure and illustrate socioeconomic-related inequality in short birth interval, respectively. Decomposition analysis was performed to identify factors explaining the socioeconomic-related inequality in short birth interval. Results The Erreygers normalized concentration index for short birth interval was − 0.0478 (SE = 0.0062) and differed significantly from zero (P

Satar Rezaei,1 Halasa-Rappel Yara A2 1Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; 2Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USACorrespondence: Satar RezaeiResearch Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, IranEmail satarrezaei@gmail.comIntroduction: Little information exists on the status of oral hygiene behavior (OHB) and socioeconomic inequalities in developing countries like Iran. The aim of this study was to assess OHB and its determinants and socioeconomic inequality among schoolchildren in western Iran during 2018.Methods: A cross-sectional survey was conducted on 1,457 students aged 12– 15 years living in Kermanshah city, western Iran. We used multistage sampling to select the samples. A self-administrated questionnaire was used to collect data on OHB, sociodemographic characteristics, and economic status of the households of students. Multivariate logistic regression was used to examine the association between OHB and its determinants. We used the relative concentration index, normalized (RCIn) and a concentration curve (CC) to examine socioeconomic-related inequality in OHB.Results: The study indicated that crude and age-adjusted prevalence of good OHB was 14.61% (95% CI 12.89%– 16.53%) and 15.17% (95% CI 13.22%– 17.35%), respectively. Logistic regression analysis showed that sex, mother’s education, socioeconomic status, and oral health literacy had a statistically significant positive impact on OHB. RCIn (0.2582, 95% CI0.1770– 0.3395) values and the CC indicated that good OHB was more concentrated among the richer children.Conclusion: This study provides evidence that good OHB was less prevalent, signifying that oral health remains a public-health concern in Iran. Effective polices aimed at improving the socioeconomic status of households and mother’s education can contribute positively and to the prevention of oral disorders among schoolchildren.Keywords: schoolchildren, oral health behaviors, concentration curve, logistic regression

Background: In India, health expenditure accounts for

Background: Addressing health inequity is a top priority for achieving sustainable development goals. The existing evidences in Ethiopia have shown that there are substantial inequalities in the use of health services among various socioeconomic strata. Therefore, the present study aimed to measure socioeconomic inequalities and the contributing factors in postnatal health checks for newborns in Ethiopia., Methods: We used a secondary data from the recent 2019 Ethiopia Mini Demographic and Health Survey dataset. The study includes a weighted sample of 2,105 women who gave birth in the 2 years preceding to the survey. The study participants were selected using two stage cluster sampling techniques. The socioeconomic inequality in postnatal health checks for newborns was measured using the Erreygers Normalized Concentration Index (ECI) and illustrated by the concentration curve. A decomposition analysis was done to identify factors contributing to the socioeconomic related inequality in postnatal health checks for newborns in Ethiopia., Results: The concentration curve of postnatal health checks for newborns lay below the line of equality, and the Erreygers normalized concentration index was 0.133, with a standard error = 0.0333, and a p value <0.001; indicating that the postnatal health check for newborns was disproportionately concentrated among newborns with higher socioeconomic status. The decomposition analysis reported that antenatal care (ANC) visit (59.22%), household wealth index (34.43%), and educational level of the mother (8.58%) were the major contributors to the pro-rich socioeconomic inequalities in postnatal health checks for newborns., Conclusion: The finding revealed that there is a pro-rich inequality in postnatal health checks for newborns in Ethiopia. To reduce the observed socioeconomic health inequality, the government needs to improve ANC visits, implement strategies to access health service for economically disadvantaged groups, and increase educational attainment among women., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hagos, Tiruneh, Abera, Tsega, Endawkie, Negash, Workie, Yohannes, Getnet, Worku, Belay, Asmare, Alemu, Geberu, Demissie and Jejaw.)

Introduction: in recent times, the assertion of non-communicable diseases afflicting the rich has been demystified but cuts across the rich and the poor. Individuals in all categories of wealth quintiles are affected by the risk factors of non-communicable diseases such as alcohol consumption, tobacco use, unhealthy dietary practices and physical inactivity. However, information on the distribution of these risk factors across different socio-economic status is scanty. This study assessed the distribution of wealth quintiles and the risk factors of non-communicable diseases, using the concentration curve model. Methods: it was a quantitative study with analytical design using the Ghana Demographic and Health Survey (GDHS), 2014 data. The variables of interest were income status of respondents and risk factors of non-communicable diseases. In the analysis, income levels were categorized into wealth quintiles with assigned percentages (25%, 50%, 75% and 100%) denoting poor, rich, richer and richest respectively. The risk factors of non-communicable diseases were also categorized and assigned percentages (relatively exposed 25%, exposed 50%, more exposed 75% and most exposed 100%). A concentration table was employed to assess the risk factors of non-communicable diseases labelled X-axis and wealth quintiles labelled Y-axis. The cumulative percentage of the wealth quintiles (Y-axis) were plotted against the cumulative percentage of the risk factors of non-communicable diseases on the X-axis. Results: the study found moderate concentration of alcohol consumption among the middle to upper wealth quintiles (richest). Again, the study revealed that, wealth quintiles are practically indifferent to tobacco use and that both the rich and poor equally and minimally use tobacco as the concentration curve is very close to the perfect line of equality (45°). This study found near equal distribution of unhealthy dietary practices among the rich and poor in Ghana. It was found that, 40% - 80% of rich people were physically inactive with the application of a physical activity level of 100%. It was noticed that, 40% of the rich people only performed 20% of physical activities. Conclusion: the study concludes that; wealth quintiles have implications for the risk factors of non-communicable diseases. [ABSTRACT FROM AUTHOR]

This study aims to quantify socioeconomic inequalities—and the factors contributing to these inequalities—in measles vaccine uptake among children aged 12 to 23 months in Ethiopia between 2005 and 2016. Inequalities in measles vaccine uptake were investigated based on data from the Ethiopian Demographic and Health Surveys conducted in 2005, 2011, and 2016. Concentration curves and concentration indices were used to measure the degree of inequality, and decomposition analysis was used to identify factors contributing to these inequalities. The overall level of national measles vaccine uptake in Ethiopia exhibited an increasing trend between 2005 and 2016. As indicated by the concentration index of measles vaccine uptake, however, which was estimated at 0.202 (P <.01) in 2005, 0.226 (P <.01) in 2011, and 0.223 (P <.01) in 2016, measles vaccine uptake became consistently more concentrated among children from more affluent households. The dominance test of the concentration curve further confirmed the persistence of inequalities in measles vaccine uptake over time. Various factors—including maternal educational level, antenatal care use, institutional delivery, and exposure to media—were identified as the most important contributors to the inequalities. Although the national measles vaccine uptake showed improvement between 2005 and 2016, socioeconomic inequalities in the uptake persisted over time. Efforts to improve the national immunization coverage should be accompanied by appropriate measures to address the inequalities. • National measles vaccine uptake has exhibited an increasing trend since its introduction in Ethiopia. • In Ethiopia, significant socioeconomic-related inequalities in measles vaccine uptake have persisted over time between the years 2005 and 2016. • Maternal educational level, antenatal care use, institutional delivery, and exposure to media were the major contributing factors for the observed inequalities. • Any policy measures taken in the country to improve measles vaccine uptake should take equity into account. [ABSTRACT FROM AUTHOR]

Background: As the world is still being ravaged by the coronavirus disease 2019 (COVID-19) pandemic, the first line of prevention lies in understanding the causative and preventive factors of the disease. However, given varied socioeconomic circumstances, there may be some inequality in the level of proper knowledge of COVID-19. Despite a proliferation of studies on COVID-19, the extent and prevalence of inequalities in knowledge about COVID-19 in Saudi Arabia are not known. Most related studies have only focused on understanding the determinants of COVID-19 knowledge. Therefore, the aim of this study was to assess the socioeconomic inequalities in knowledge regarding COVID-19 in Saudi Arabia.Methods: Data were extracted from an online cross-sectional self-reported questionnaire conducted on the knowledge about COVID-19 from 3,388 participants. Frequencies and graphs were used to identify the level and distribution of inequality in knowledge about COVID-19. Concentration curves and concentration indices were further used to assess and quantify the income- and education-related inequality in knowledge about COVID-19.Results: The level of COVID-19 knowledge was high among the surveyed sample, although the extent of knowledge varied. The findings further suggest the existence of socioeconomic inequality in obtaining proper knowledge about COVID-19, indicating that inequality in comprehensive knowledge is disproportionately concentrated among the wealthy (concentration index = 0.016; P < 0.001) and highly educated individuals (concentration index = 0.003; P = 0.029) in Saudi Arabia.Conclusions: There is inequality in the level of knowledge about COVID-19 among the more socioeconomically privileged population of Saudi Arabia. Given that COVID-19 cases ebb and flow in different waves, it is important that proper policies be put in place that will help in improving knowledge among the lower income and less educated individuals, leading to behavior that can help reduce transmission.

Obtaining fast and accurate access to disaster information for underground mines is key in order to enact safe and effective emergency rescue measures. This study proposes a method to remotely evaluate the damage status in underground mines after a mine accident by using a tracer gas. This discussion includes the laws of migration, mixing and separating the tracer gas in the airway, and the superposition of the tracer gas concentration curve conforms to the Gaussian Mixture Model (GMM), which can be decomposed by the expectation-maximization (EM) algorithm. Based on the EM algorithm, the tracer gas method can assess the location and severity of the airway damage. The results show that the error between the calculated damage location and the actual damage location is very small. In addition, the area ratio of the concentration curve after the decomposition by the EM algorithms is highly correlated with the severity of the airway damage. This study demonstrates that the tracer gases can be used to remotely evaluate the location and severity of a mine accident, which is critical in order to perform successful rescue and emergency management. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) has resulted in an enormous dislocation of society especially in South Africa. The South African government has imposed a number of measures aimed at controlling the pandemic, chief being a nationwide lockdown. This has resulted in income loss for individuals and firms, with vulnerable populations (low earners, those in informal and precarious employment, etc.) more likely to be adversely affected through job losses and the resulting income loss. Income loss will likely result in reduced ability to access healthcare and a nutritious diet, thus adversely affecting health outcomes. Given the foregoing, we hypothesize that the economic dislocation caused by the coronavirus will disproportionately affect the health of the poor. Methods: Using the fifth wave of the National Income Dynamics Study (NIDS) dataset conducted in 2017 and the first wave of the NIDS-Coronavirus Rapid Mobile Survey (NIDS-CRAM) dataset conducted in May/June 2020, this paper estimated income-related health inequalities in South Africa before and during the COVID-19 pandemic. Health was a dichotomized self-assessed health measure, with fair and poor health categorized as "poor" health, while excellent, very good and good health were categorized as "better" health. Household per capita income was used as the ranking variable. Concentration curves and indices were used to depict the income-related health inequalities. Furthermore, we decomposed the COVID-19 era income-related health inequality in order to ascertain the significant predictors of such inequality. Results: The results indicate that poor health was pro-poor in the pre-COVID-19 and COVID-19 periods, with the latter six times the value of the former. Being African (relative to white), per capita household income and household experience of hunger significantly predicted income-related health inequalities in the COVID-19 era (contributing 130%, 46% and 9% respectively to the inequalities), while being in paid employment had a nontrivial but statistically insignificant contribution (13%) to health inequality. Conclusions: Given the significance and magnitude of race, hunger, income and employment in determining socioeconomic inequalities in poor health, addressing racial disparities and hunger, income inequality and unemployment will likely mitigate income-related health inequalities in South Africa during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Abstract In Nepal, the prevalence of anaemia decreased by 1% from 2006 to 2011 but increased by 6% from 2011 to 2016. In this study, we examined the changes in prevalence by possible factors from 2006 to 2016 along with the factors associated with anaemia among women of reproductive age (15–49 years) using the Nepal Demographic and Health Survey (NDHS) data from years 2006, 2011 and 2016. We used rate of change analysis to explore average annual rate of change (AARC) in anaemia prevalence and concentration curves and indices to assess unequal distribution of anaemia prevalence among socio‐economic quintiles. Multilevel regression was performed to examine the association of multilevel factors with anaemia. Our results showed higher AARC increase in anaemia prevalence from 2006 to 2016, among women aged 30–39 years, with secondary or higher education, who had two or fewer children, not working women, from higher wealth quintiles and who were overweight or obese. Shifting of concentration curve from ‘above the line of equality’ in 2006 and 2011 to ‘under the line of equality’ in 2016 was observed. Women aged 20–29 years, with more than four children, who underwent female sterilization, had experienced violence and from Provinces 1, 2 and 5 were at higher risk of anaemia. Overweight and obese women using hormonal contraception and from lowest wealth quintiles were at lower risk. The change in trends and the associated multilevel factors identified should be considered in designing multilevel interventions that particularly target women at risk for sustainable anaemia reduction.

A very key point in the process of the Covid-19 contagion control is the introduction of effective policy measures, whose results have to be continuously monitored through accurate statistical analysis. To this aim we propose an innovative statistical tool, based on the Gini-Lorenz concentration approach, which can reveal how well a country is doing in reducing the growth of contagion, and its speed.

Background: Short birth interval, defined as a birth-to-birth interval less than 33 months, is associated with adverse maternal and child outcomes. Evidence regarding the association of maternal socioeconomic status and short birth interval is inconclusive. Factors contributing to the socioeconomic inequality of short birth interval have also not been investigated. The current study assessed socioeconomic inequality in short birth interval and its contributing factors in Ethiopia.Methods: Data from 8448 women collected in the 2016 Ethiopia Demographic and Health survey were included in the study. Socioeconomic inequality in short birth interval was the outcome variable. Erreygers normalized concentration index (ECI) and concentration curves were used to measure and illustrate socioeconomic-related inequality in short birth interval, respectively. Decomposition analysis was performed to identify factors explaining the socioeconomic-related inequality in short birth interval.Results: The Erreygers normalized concentration index for short birth interval was - 0.0478 (SE = 0.0062) and differed significantly from zero (P < 0.0001); indicating that short birth interval was more concentrated among the poor. Decomposition analysis indicated that wealth quintiles (74.2%), administrative regions (26.4%), and not listening to the radio (5.6%) were the major contributors to the pro-poor socioeconomic inequalities in short birth interval.Conclusion: There was a pro-poor inequality of short birth interval in Ethiopia. Strengthening the implementation of poverty alleviation programs may improve the population's socioeconomic status and reduce the associated inequality in short birth interval. [ABSTRACT FROM AUTHOR]

In Nepal, the prevalence of anaemia decreased by 1% from 2006 to 2011 but increased by 6% from 2011 to 2016. In this study, we examined the changes in prevalence by possible factors from 2006 to 2016 along with the factors associated with anaemia among women of reproductive age (15–49 years) using the Nepal Demographic and Health Survey (NDHS) data from years 2006, 2011 and 2016. We used rate of change analysis to explore average annual rate of change (AARC) in anaemia prevalence and concentration curves and indices to assess unequal distribution of anaemia prevalence among socio‐economic quintiles. Multilevel regression was performed to examine the association of multilevel factors with anaemia. Our results showed higher AARC increase in anaemia prevalence from 2006 to 2016, among women aged 30–39 years, with secondary or higher education, who had two or fewer children, not working women, from higher wealth quintiles and who were overweight or obese. Shifting of concentration curve from 'above the line of equality' in 2006 and 2011 to 'under the line of equality' in 2016 was observed. Women aged 20–29 years, with more than four children, who underwent female sterilization, had experienced violence and from Provinces 1, 2 and 5 were at higher risk of anaemia. Overweight and obese women using hormonal contraception and from lowest wealth quintiles were at lower risk. The change in trends and the associated multilevel factors identified should be considered in designing multilevel interventions that particularly target women at risk for sustainable anaemia reduction. [ABSTRACT FROM AUTHOR]

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Abstract The paper develops and illustrates a new multivariate approach to analysing inequity in health care. We measure multiple inequity in health care relating to multiple equity-relevant variables – including income, gender, ethnicity, rurality, insurance status and others – and decompose the contribution of each variable to multiple inequity. Our approach encompasses the standard bivariate approach as a special case in which there is only one equity-relevant variable, such as income. We illustrate through an application to physician visits in Brazil, using data from the Health and Health Care Supplement of the Brazilian National Household Sample Survey, comprising 391,868 individuals in the year 2008. We find that health insurance coverage and urban location both contribute more to multiple inequity than income. We hope this approach will help researchers and analysts shed light on the comparative size and importance of the many different inequities in health care of interest to decision makers, rather than focus narrowly on income-related inequity. Highlights • We developed methods for measuring multiple inequity in health care. • Multiple inequity relates to multiple equity-relevant variables, not just income. • We analysed multiple inequity in physician visits in Brazil using survey data. • Insurance coverage and geography contributed more to multiple inequity than income. [ABSTRACT FROM AUTHOR]

Background: Geographical maldistribution has been a critical concern of health workforce planning in Thailand for years. This study aimed to assess the equity of health workforce distribution in public hospitals affiliated to the Office of Permanent Secretary (OPS) of the Ministry of Public Health (MOPH) through the application of "concentration index" (CI). Methods: A cross sectional quantitative design was employed. The dataset comprised 1) health workforce data from the OPS, MOPH in 2016, 2) regional and provincial-level economic data from the National Economic and Social Development Board in 2015, and 3) population data from the Ministry of Interior in 2015. Descriptive statistics, Spearman's rank correlation, and CI analysis were performed. Results: Thailand had 2.04 health professionals working in public facilities per 1,000 population. Spearman's correlation found positive relationship in all health professionals. Yet, statistical significance was not found in most health professionals but doctors (P<0.001). Positive correlation was observed in all health cadres at regional and provincial hospitals (rs=0.348, P=0.002). In the CI analysis, the distribution of health professionals across provincial income was relatively equitable in all cadres. Significant CIs were found in doctor density (CI =0.055, P=0.001), all professionals density at district hospitals (CI =–0.049, P=0.012), and all professionals density at provincial and regional hospitals (CI =0.078, P=0.003). Conclusion: The positive CIs implied that the distribution of all health professionals, especially doctors, at provincial and regional hospitals slightly favored the richer provinces. In contrast, the distribution at district hospitals was slightly more concentrated in less well-off provinces. From a macro-view, the distribution of all health professionals in Thailand was relatively equitable across provincial economic status. This might be due to the extensive health infrastructure development and rural retention policies over the past four decades. [ABSTRACT FROM AUTHOR]

Long-distance pipelines transporting multiple product oils such as gasoline, diesel and jet fuel, are important facilities for transporting fossil energy. One major concern in operation is the energy consumption of the pipeline. Energy consumption should be made optimized tracking batches of oils and cutting mixed oil, which requires an accurate prediction of concentration curve. In engineering, the concentration curve is usually assumed to be symmetric, but it is actually asymmetric, which may lead to estimation errors. Thus, the asymmetric concentration of mixed oil should be studied. The formation mechanism of the asymmetry of concentration curve has not been clearly clarified. A new method is proposed to measure the asymmetry of the concentration curve. Quantitative analysis is carried out for each factor on the asymmetry distribution of concentration curve. Based on the convection–diffusion equation, a modified oil-mixing model considering near wall adsorption effect is established. The model shows a good agreement with the Jablonski empirical formula. The error, compared with the experimental results, is less than 5%. The main findings are: (1) deviation volume has a negative correlation with pipe diameter and mean velocity; (2) adsorption coefficient has a greater impact on the length ratio of front and tail oil than diffusion coefficient; (3) the influence of all factors considered on the total length of mixed oil, front oil, tail oil and trail oil are basically the same; (4) if the limit of adsorption concentration in adsorption layer is 1, the reasonable value of adsorption coefficient a and b should be around 0.4. The results reveal the mechanism of asymmetric concentration of product oils and can provide practical suggestions to deal with the mixed oil.

Consumption tax reform should aim to improve social welfare. In this paper, an extending of welfare dominance method is given from individual data to group data, the concentration curve of group data is used to express the concept of welfare dominance in commodity under the condition of income marginal utility positive and decreasing. Inequality disgust parameter is introduced into income elasticity, which is one of most important property described welfare dominance, and a method for group data is provided to calculate accurately sample extended income elasticity. An application example is provided to explain welfare dominance approach using Chinese provincial data of eight types expenditure of consumption of urban and rural residents in 2013; research results indicate that will improve social welfare and provide the direction of tax adjusting in commodity spent by Chinese urban and rural residents, to subsidize urban residents consumption expenditure of food, clothing, residence, household facilities and articles, health care and medical services, or to subsidize rural residents household facilities and articles. [ABSTRACT FROM AUTHOR]

Background: Equity is one of the pivotal aims and priorities of the pharmaceutical system. The World Health Organization report in 2000 clarifies the important role of equity in health-care systems. Equity and efficiency are prominent features of health-care system operation. Pharmaceuticals play an important role in the cycle of health services. The aim of this study was to evaluate the equity in access to pharmaceutical services in selected cities of Isfahan Province, Iran. Methods: This research is a cross-sectional analytical study. A valid, reliable questionnaire including 25 questions was prepared to measure patients’ access to their prescribed medicines and also to determine their socioeconomic status (SES). Totally 800 questionnaires were completed by patients who attended pharmacies in selected cities of Isfahan Province. Equity in access was evaluated using concentration and Lorenz curves. Results: Nearly 66% of the samples were categorized in moderate-to-extremely poor SES. The highest rate of access to pharmaceutical services was found in Borkhar and Meymeh (98.9%) and the least was in Natanz (90.5%). The concentration index (CI) for access to pharmaceutical services was 0.029 in Isfahan Province, and thus equitable access to pharmaceutical services was estimated to be about 97% in this province. Conclusion: The CI for access to pharmaceutical services was 0.029 in Isfahan Province. The findings show that the pattern of accessibility is not significantly different between the cities with various development indicators and is not related with various SES. This could be considered as one of the positive features of pharmaceutical policy in Iran.