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Equality of opportunity is about leveling the playing field so that circumstances such as gender, ethnicity, place of birth, or family background do not influence a person's life chances. Success in life should depend on people's choices, effort and talents, not to their circumstances at birth. 'Measuring Inequality of Opportunities in Latin America and the Caribbean' introduces new methods for measuring inequality of opportunities and makes an assessment of its evolution in Latin America over a decade. An innovative Human Opportunity Index and other parametric and non-parametric techniques are presented for quantifying inequality based on circumstances exogenous to individual efforts. These methods are applied to gauge inequality of opportunities in access to basic services for children, learning achievement for youth, and income and consumption for adults.

This paper uses a partial equilibrium framework to evaluate the relative efficiency, distributional and revenue implications of rice tariffs and targeted transfers in Madagascar, especially in the context of identifying their respective roles for poverty alleviation. Although there are likely to be substantial efficiency gains from tariff reductions, these accrue mainly to higher income households. In addition, poor net rice sellers will lose from lower tariffs. Developing a system of well designed and implemented targeted direct transfers to poor households is thus likely to be a substantially more costeffective approach to poverty alleviation. Such an approach should be financed by switching revenue raising from rice tariffs to more efficient tax instruments. These policy conclusions are likely to be robust to the incorporation of general equilibrium considerations.

Introduction Cancer is a major public health challenge in Germany with significant socioeconomic inequalities in incidence and mortality. However, there is only limited research on the incidence of diagnosis-specific cancers and related inequalities among socioeconomic groups within the working-age population. This study aims to address this gap by analysing how the incidence of common cancers depends on individual- and area-level socioeconomic characteristics among working-age women and men.  Methods Using a prospective cohort design based on anonymised German statutory health insurance data, this study examined a cohort of 2.23 million individuals aged 25–67 years over a five-year period (2015–2019). Individual socioeconomic position was assessed using educational attainment and occupational skill levels, while area-level deprivation was determined using a composite socioeconomic index. Incidence rates were estimated per 100,000 person-years at risk, age-standardised to the 2013 European standard population. Hazard ratios were calculated using multilevel Cox proportional hazards models. Results The analysis revealed 50,276 newly diagnosed cancer cases during the study period. Lower education, lower occupational skill levels and higher area-level deprivation were associated with a higher incidence of stomach, lung, colorectal, prostate, breast and cervical cancer, but a lower incidence rate of malignant melanoma of the skin. After mutual adjustment of the socioeconomic indicators, higher hazard ratios of lung cancer were found for men with lower educational (HR = 2.8, 95%CI:2.3–3.5) and occupational skill levels (HR = 2.8, 95%CI:2.3–3.5) and for women with lower education (HR = 2.3, 95%CI:1.7–3.1). Lower occupational skill levels in both sexes (women HR = 0.6, 95%CI:0.5–0.7; men HR = 0.7, 95%CI:0.6–0.9) and lower educational levels in men (HR = 0.7, 95%CI:0.6–0.8) were independently associated with a lower risk of malignant melanoma. For area-level deprivation, we observed a higher risk of stomach (women 1.6, 95%CI:1.2-2.0; men HR = 1.3, 95%CI:1.1–1.6) and lung cancer (women HR = 1.3, 95%CI:1.1–1.5; men HR = 1.5, 95%CI:1.3–1.7) in more deprived areas, even after adjusting for individual-level socioeconomic characteristics. In contrast, a higher risk of skin melanoma was observed in less deprived areas after individual-level socioeconomic adjustments (women and men HR = 0.6, 95%CI:0.5–0.7). Conclusions Our findings suggest that strategies to prevent cancer in the working-age population should take more account of the unequal structural conditions in which people work and live. The study shows that area-level socioeconomic deprivation has explanatory power for unequal cancer risks beyond the individual characteristics of socioeconomic position.

Background In New Haven County, CT (NHC), influenza hospitalization rates have been shown to increase with census tract poverty in multiple influenza seasons. Though multiple factors have been hypothesized to cause these inequalities, including population structure, differential vaccine uptake, and differential access to healthcare, the impact of each in generating observed inequalities remains unknown. We can design interventions targeting factors with the greatest explanatory power if we quantify the proportion of observed inequalities that hypothesized factors are able to generate. Here, we ask if population structure is sufficient to generate the observed area-level inequalities in NHC. To our knowledge, this is the first use of simulation models to examine the causes of differential poverty-related influenza rates. Methods Using agent-based models with a census-informed, realistic representation of household size, age-structure, population density in NHC census tracts, and contact rates in workplaces, schools, households, and neighborhoods, we measured poverty-related differential influenza attack rates over the course of an epidemic with a 23 % overall clinical attack rate. We examined the role of asthma prevalence rates as well as individual contact rates and infection susceptibility in generating observed area-level influenza inequalities. Results Simulated attack rates (AR) among adults increased with census tract poverty level (F = 30.5; P  < 0.001) in an epidemic caused by a virus similar to A (H1N1) pdm09. We detected a steeper, earlier influenza rate increase in high-poverty census tracts—a finding that we corroborate with a temporal analysis of NHC surveillance data during the 2009 H1N1 pandemic. The ratio of the simulated adult AR in the highest- to lowest-poverty tracts was 33 % of the ratio observed in surveillance data. Increasing individual contact rates in the neighborhood did not increase simulated area-level inequalities. When we modified individual susceptibility such that it was inversely proportional to household income, inequalities in AR between high- and low-poverty census tracts were comparable to those observed in reality. Discussion To our knowledge, this is the first study to use simulations to probe the causes of observed inequalities in influenza disease patterns. Knowledge of the causes and their relative explanatory power will allow us to design interventions that have the greatest impact on reducing inequalities. Conclusion Differential exposure due to population structure in our realistic simulation model explains a third of the observed inequality. Differential susceptibility to disease due to prevailing chronic conditions, vaccine uptake, and smoking should be considered in future models in order to quantify the role of additional factors in generating influenza inequalities.

Whether and how societal structures shape individual psychology is a foundational question of the social sciences. Combining insights from evolutionary biology, economy, and the political and psychological sciences, we identify a central psychological process that functions to sustain group-based hierarchies in human societies. In study 1, we demonstrate that macrolevel structural inequality, impaired population outcomes, socio-political instability, and the risk of violence are reflected in the endorsement of group hegemony at the aggregate population level across 27 countries (n = 41,824): The greater the national inequality, the greater is the endorsement of between-group hierarchy within the population. Using multilevel analyses in study 2, we demonstrate that these psychological group-dominance motives mediate the effects of macrolevel functioning on individual-level attitudes and behaviors. Specifically, across 30 US states (n = 4,613), macrolevel inequality and violence were associated with greater individual-level support of group hegemony. Crucially, this individual-level support, rather than cultural-societal norms, was in turn uniquely associated with greater racism, sexism, welfare opposition, and even willingness to enforce group hegemony violently by participating in ethnic persecution of subordinate out-groups. These findings suggest that societal inequality is reflected in people’s minds as dominance motives that underpin ideologies and actions that ultimately sustain group-based hierarchy.

The need for a multidimensional measure of population health that accounts for its distribution remains a central problem to guide the allocation of limited resources. Absolute proxy measures, like the infant mortality rate (IMR), are limited because they ignore inequality and spatial clustering. We propose a novel, three-part, multidimensional mortality indicator that can be used as the first step to differentiate interventions in a region or country. The three-part indicator (MortalityABC index) combines absolute mortality rate, the Theil Index to calculate mortality inequality and the Getis-Ord G statistic to determine the degree of spatial clustering. The analysis utilises global sub-national IMR data to empirically illustrate the proposed indicator. The three-part indicator is mapped globally to display regional/country variation and further highlight its potential application. Developing countries (e.g. in sub-Saharan Africa) display high levels of absolute mortality as well as variable mortality inequality with evidence of spatial clustering within certain sub-national units (\"hotspots\"). Although greater inequality is observed outside developed regions, high mortality inequality and spatial clustering are common in both developed and developing countries. Significant positive correlation was observed between the degree of spatial clustering and absolute mortality. The proposed multidimensional indicator should prove useful for spatial allocation of healthcare resources within a country, because it can prompt a wide range of policy options and prioritise high-risk areas. The new indicator demonstrates the inadequacy of IMR as a single measure of population health, and it can also be adapted to lower administrative levels within a country and other population health measures.

This chapter contains sections titled: The Prevalence of Peer Violence Changes in Peer Violence? Who is Involved in Peer Violence? Government Responses Implications for Professionals Final Thoughts References

This study examines the structural correlates of Hispanic suicide at the metropolitan level using Mortality Multiple Cause-of-Death Records and 2000 census data. The authors test competing hypotheses regarding the effects of immigration, assimilation, affluence, economic disadvantage, and ethnic inequality on suicide levels for Hispanics as a whole and disaggregated by immigrant status. The findings point to multiple forces and complex relationships among social structure, culture, and Hispanic suicide. The findings also suggest that these factors have unique effects on native-born versus immigrant populations. This is the first study to determine the structural correlates of suicide among Hispanics and to assess the macrolevel influence of immigration and cultural assimilation on ethnic-specific suicide. [PUBLICATION ABSTRACT]

This chapter contains sections titled: Abstract Introduction Socio‐Economic Inequalities in Suicide: The Evidence New Empirical Investigation of Socio‐Economic Inequalities in Suicide in Scotland Discussion Conclusion References