UNASSIGNED: - Coal mining areas in the UK continue to suffer worse health outcomes despite the industry disappearing by the early 1990s. Unemployment and deprivation are cited as key explanations. However, as the health effects of hazardous working environments continue after the industry\'s closure, it is unclear to what extent this ongoing health deficit is due to the legacy health effect of coal mining versus socioeconomic factors, including unemployment and deprivation.
UNASSIGNED: - I isolate the legacy health effect of coal mining using a matching research design. Coal mining areas are paired with non-mining areas using propensity score matching. This creates a sample of socioeconomically similar local authority districts in England and Wales. I estimate the effect of coal mining on male and female age-standardised period mortality rates for 1981-2019, analysing temporal dynamics and testing for convergence.
UNASSIGNED: - I find an initial coal mining effect in 1981 on male (female) mortality rates of 122.6 (66.5) deaths per 100,000. This effect decreases by 91% (70%) during this period, indicating convergence in mortality rates. The timing of this convergence is consistent with that of the industry\'s closure, with higher convergence rates observed during the 1990s.
UNASSIGNED: - These results provide evidence for a legacy health effect on mortality from coal mining and convergence in mortality rates between 1981 and 2019. This effect is important when explaining the health deficit experienced by coal mining areas. Furthermore, as coal mining areas tend to be more deprived, these results also shed light on relevant mechanisms driving recent health inequality in the UK.

Service users living with Obsessive compulsive disorder (OCD) often delay or avoid seeking diagnosis or treatment because of a fear of judgement or feelings of shame associated with their obsessions and compulsions. They may feel that their behaviour defies societal norms, which can lead to social isolation, and in turn, further contribute to health inequality. When such individuals present with physical illness and are seen by district nurses, it is imperative that behaviours are understood and approached appropriately. It is important to develop therapeutic relationships and consider their holistic wellbeing. Developing a close working relationship with the mental health team as a multidisciplinary team and using the team as a resource may contribute to the overall health outcome of service users with OCD.

In 1986, the Ottawa Charter established health promotion as a central objective of governments in order to reduce health inequalities. It is a key concept that forms an integral part of nurses\' training and missions.

Whether positively or negatively, an individual\'s geographical location has an impact on his or her state of health. Often described as a \"catchword\", the notion of territory is complex to define. To better understand its influence, we\'ll be looking at the different territorial scales, as well as the responses of populations to these issues. With this in mind, we\'ll take a look at how healthcare professionals are changing their practices.

Social inequalities in health refer to differences in health status between people or groups of people, linked to factors that are particularly social, unequal and considered morally or ethically unacceptable. These may be major differences in life expectancy, or in the greater likelihood of being a carrier of disease, depending on the social group to which one belongs or the territory in which one lives. Accentuated during a health crisis, they are, however, avoidable.

BACKGROUND: Life situation dimensions, such as financial resources, housing, health and social relationships, have a significant influence on the scope available to older people for coping with everyday life and participation and thus for a good life in old age.
METHODS: As a basis for identifying current and future challenges posed by precarious living conditions in old age, current publicly available data and study results on the income situation, housing, health and care are reported as central dimensions of the living conditions of people aged 65 years and over in Germany.
RESULTS: The study results presented provide indications as to which groups of older people live in particularly precarious living situations, which provide starting points for municipal action. Inequalities exist in the availability of income, affordable and accessible housing, social networks, health opportunities and care support services. Particular importance is attached to the risk of poverty, which goes hand in hand with the risk of disadvantages in the other dimensions analyzed.
UNASSIGNED: HINTERGRUND: Lebenslagedimensionen wie finanzielle Mittel, Wohnen, Gesundheit und soziale Beziehungen beeinflussen wesentlich die Spielräume, die alten Menschen für Alltagsbewältigung und Teilhabe und damit für ein gutes Leben im Alter zur Verfügung stehen.
METHODS: Als Grundlage für die Identifizierung aktueller und zukünftiger Herausforderungen durch prekäre Lebenslagen im Alter werden aktuelle, öffentlich verfügbare Daten und Studienergebnisse zu Einkommenssituation, Wohnen, sozialen Beziehungen, Gesundheit und Pflege als zentrale Dimensionen der Lebensbedingungen von Menschen ab 65 Jahren in Deutschland berichtet.
UNASSIGNED: Die präsentierten Studienergebnisse geben Hinweise, welche Gruppen von Älteren in besonders prekären Lebenslagen leben, aus denen sich Anknüpfungspunkte für kommunales Handeln ergeben. Ungleichheiten bestehen in der Verfügbarkeit von Einkommen, bezahl- und barrierearmem Wohnraum, sozialen Netzwerken, Gesundheitschancen sowie pflegerischen Unterstützungsleistungen. Besondere Bedeutung kommt der Armutsgefährdung, die mit dem Risiko für Benachteiligungen in den weiteren betrachteten Dimensionen einhergeht, zu.

Whether maternal exposure to dust-sourced particulate matter (hereafter, dust PM2.5) is associated with stillbirth remains unknown. We adopted a sibling-matched case-control design to analyze 9332 stillbirths and 17,421 live births. We associated the risk of stillbirth simultaneously with dust and nondust components of PM2.5 and developed a nonlinear joint exposure-response function. Next, we estimated the burden of stillbirths attributable to the PM2.5 mixture. The concentration index was used to evaluate whether the burden of PM2.5-related stillbirths was disproportionally distributed among pregnancies exposed to dust-rich particles. Each 10 μg/m3 increase in dust PM2.5 was associated with a 14.5% (95% confidence interval: 5.5, 24.2%) increase in the odds of stillbirth. Based on the risk assessment across 137 countries, sand dust contributed to about 15% of the PM2.5 exposure but to about 45% of the PM2.5-related stillbirths during 2003-2019. In 2015, 30% of the PM2.5-related stillbirths were concentrated within 15% of pregnancies exposed to the dust-richest PM2.5. The index increased in subregions, such as South Asia, suggesting the growth of health inequality due to exposure to dust PM2.5. Based on our findings, land management, such as halting desertification, will help prevent stillbirths and reduce global maternal health inequality.

UNASSIGNED: Socio-economic background is often an important determinant for health with low income households having higher exposure to risk factors and diminished access to healthcare and prevention, in a way that is specific to each country.
UNASSIGNED: Here, we perform a comparative analysis of the relations between health and income inequality in two developed countries, USA and Italy, using longitudinal and cross-sectional data from surveys.
UNASSIGNED: We show that the income class determines the incidence of chronic pathologies, associated risk-factors and psychiatric conditions, but find striking differences in health inequality between the two countries. We then focus our attention on a fraction of very disadvantaged households in the USA whose income in persistently at the bottom of the distribution over a span of 20 years and which is shown to display particularly dire health conditions. Low income people in the USA also display comorbidity patterns that are not found in higher income people, while in Italy income appears to be less relevant for comorbidity. Taken together our findings illustrate how differences in lifestyle and the healthcare systems affect health inequality.

BACKGROUND: Since 2020, China has piloted an innovative payment method known as the Diagnosis-Intervention Packet (DIP). This study aimed to assess the impact of the DIP on inpatient volume and bed allocation and their regional distribution. This study investigated whether the DIP affects the efficiency of regional health resource utilization and contributes to disparities in health equity among regions.
METHODS: We collected data from a central province in China from 2019 to 2022. The treatment group included 508 hospitals in the pilot area (Region A, where the DIP was implemented in 2021), whereas the control group consisted of 3,728 hospitals from non-pilot areas within the same province. We employed the difference-in-differences method to analyze inpatient volume and bed resources. Additionally, we conducted a stratified analysis to examine whether the effects of DIP implementation varied across urban and rural areas or hospitals of different levels.
RESULTS: Compared with the non-pilot regions, Region A experienced a statistically significant reduction in inpatient volume of 14.3% (95% CI 0.061-0.224) and a notable decrease of 9.1% in actual available bed days (95% CI 0.041-0.141) after DIP implementation. The study revealed no evidence of patient consultations shifting from inpatient to outpatient services due to the reduction in hospital admissions in Region A after DIP implementation. Stratified analysis revealed that inpatient volume decreased by 12.4% (95% CI 0.006-0.243) in the urban areas and 14.7% in the rural areas of Region A (95% CI 0.051-0.243). At the hospital level, primary hospitals experienced the greatest impact, with a 19.0% (95% CI 0.093-0.287) decline in inpatient volume. Furthermore, primary and tertiary hospitals experienced significant reductions of 11.0% (95% CI 0.052-0.169) and 8.2% (95% CI 0.002-0.161), respectively, in actual available bed days.
CONCLUSIONS: Despite efforts to curb excessive medical service expansion in the region following DIP implementation, large hospitals continue to attract a large number of patients from primary hospitals. This weakening of primary hospitals and the subsequent influx of patients to urban areas may further limit rural patients\' access to medical services. The implementation of the DIP may raise concerns about its impact on health care equality and accessibility, particularly for underserved rural populations.

OBJECTIVE: Informal care provided by adult children is of great importance for older adults\' well-being in China. This paper investigates and compares the functional transitions among older adults living in rural areas who receive care from daughters\' and from sons\' families.
METHODS: This study utilizes the \'Well-being of Elderly Survey in Anhui Province\' (WESAP), from 2001 to 2021. Our sample included 2,797 individuals aged 60 years or over. Functional status was based on the activities of daily living (ADLs) and the instrumental activities of daily living (IADLs). We employed a random-effects ordered logit model to examine the functional transitions among the older adults.
RESULTS: Receiving care from daughters\' families is significantly associated with a lower likelihood of functional decline compared to receiving care from sons\' families in rural China. The advantage associated with daughter care becomes more pronounced among older individuals with a severe functional difficulty compared to those with a mild or moderate functional difficulty. The difference is prevalent among older adults aged 75 and above, with less wealth or multiple chronic diseases, or who live alone. Furthermore, among those with severe functional difficulties, the daughter advantage is more significant for fathers as compared to mothers.
CONCLUSIONS: Nowadays, daughters\' families can provide high-quality informal care, often surpassing that offered by sons\' families. This daughter advantage becomes even more significant among older adults who have a higher need for family care, such as those with severe disabilities and limited financial resources.