 |
CHAIN - The Centre for Global Health Inequalities Research
CHAIN is the leading centre and interdisciplinary research network for global health inequalities, based at the Norwegian University of Science and Technology (NTNU). It brings together expert researchers in the field of health, social determinants, civil society, and the UN system to advance health inequalities research, especially for children’s health.
Stay informed by
This newsletter was sent by EuroHealthNet on behalf of CHAIN. |
|
|
CHAIN partnership meets to discuss further collaboration and increase its impact
|
|
In May 2023, CHAIN colleagues from all over Europe and the USA gathered at the UNICEF Innocenti offices in Florence, Italy. Throughout the two-day meeting, participants presented their innovative work in the fields of inequalities related to both child health and climate change. Alongside diverse new areas of research, numerous opportunities for collaboration emerged.
The meeting also examined how to incorporate research results into policymaking processes, in turn supporting evidence-based action when addressing health inequalities. |
|
|
Global Burden of Disease and health inequality research
|
|
Developments in the CHAIN-IHME collaboration to create a 'Global Burden of Health Inequalities' database
One of the main topics on the Florence agenda in May was CHAIN’s collaboration with the Institute of Health Metrics and Evaluation (IHME) to add socioeconomic indicators to the Global Burden of Disease (GBD) study. GBD is the largest scientific endeavour of its kind - one which quantifies levels and trends in health, while ensuring its data and accompanying data tools are made publicly available. Adding socioeconomic indicators to the study effectively creates a ‘Global Burden of Health Inequalities’ database. |
|
|
 |
|
Identifying correlations between parental education and child mortality
As a result of CHAIN-IHME collaboration, ‘low education’ is planned to be added as an indicator to future GBD studies. This will lead to the most comprehensive evidence to date showing how low education is a risk factor for mortality. CHAIN researchers currently work on meta-analysis of educational inequalities in adult mortality, which includes data from more than 600 studies. The study will be published during 2023 and may be the largest meta-analysis conducted to date. Together with the CHAIN study on the links between parental education and child mortality, it will constitute the “anchor” for successful inclusion of education in the GBD.
|
 |
|
Further use of GBD data
The data from 2019’s GBD study has also been used by CHAIN researchers for other studies, including to measure inequalities in the burden of noncommunicable diseases across European countries as well as the burden of disease attributed to drug use in Nordic countries.
|
|
Sharing the work with the research community
Earlier this year, Professor Terje Andreas Eikemo, Leader of CHAIN, joined three conferences to discuss CHAIN’s collaboration with GBD in creating a ‘Global burden of Health Inequalities’ database. Watch:
|
|
|
Scandinavian Journal of Public Health
|
|
|
New edition focuses on pressing public health issues faced by migrant groups
While migrants are counted amongst society's most vulnerable groups, migration health remains a widely under-researched field and migrants are often approached as a homogeneous group. However, as data on migration and health has increased exponentially, there is a growing momentum in migration health research.
|
|
|
| In this issue of the Scandinavian Journal of Public Health, edited by CHAIN Leader Terje Andreas Eikemo, the featured studies examine pressing public health issues among migrant groups categorised according to age, country of origin, sub-population groups, duration of stay and reasons for migration. Topics included reproductive health, mental health, infectious diseases and cardiovascular diseases and the use of healthcare services. While it demonstrates progress in this field of research, the edition also illustrates the need to shed light on new complexities and interdependencies. It calls for a new research agenda stressing for example that more research and moving beyond researcher driven ‘cherry picking’ of migrant groups and topics is needed. |
|
|
Assessing the long-term health impact of COVID-19: The importance of using self-reported health measures
While it is estimated that 1 in 10 COVID-infected patients get symptoms of long COVID, data may not accurately reflect its prevalence due to a lack of clear definitions and diagnoses. In an editorial in the Scandinavian Journal of Public Health, CHAIN researchers set out the challenges of researching long COVID and the important role that data on self-reported health can play in getting a clearer picture of population health.
|
|
 |
|
How have educational inequalities in mortality rates developed over time?
While studies have shown that educational inequalities in mortality rates have changed over time, it is unclear if the same can be said from a birth cohort perspective. A CHAIN study compares changes in inequality in mortality between a period and a cohort perspective in 14 European countries, and explores mortality trends among low-educated and high-educated birth cohorts. It finds that trends in mortality inequalities by birth cohort are less favourable than by calendar period, and that inequalities may further widen.
|
 |
|
How do education levels relate to mental disorders, substance use and self-harm at different ages?
A group of CHAIN researchers set out to investigate the links between low education and risk of mental disorders, substance abuse disorders and self-harm among different age groups. Their study covered 1.6 million people born in Stockholm between 1931 and 1990, and linked them to their own or their parents’ highest level of education in 2000. Researchers followed up for these disorders in health care registers between 2001 and 2016. The study found associations between low education and higher risks of most mental disorders, of substance use disorders and of self-harm in all age-groups, but especially among those aged 28–50 years.
|
|
|
Social policies and employment
|
|
 |
|
Can low- and middle-income countries invest in pandemic preparedness in times of austerity?
The World Health Organization, World Bank and International Monetary Fund are calling on low- and middle income countries to invest in pandemic preparedness and response systems, but will they be able to? A team of CHAIN researchers found that public spending is set to decrease sharply in over half of low-and middle income countries, the key driver being external debts. This sets the stage for worsening population health, while public health services face increased needs. As a result, the authors recommend to change the global rules on debt recovery. They stress that international financial institutions such as the International Monetary Fund and World Bank must enable and support greater public spending to improve population health.
|
 |
|
What is the role of social protection policies in reducing health inequalities?
CHAIN researchers Amanda Aronsson, Clare Bambra and Terje Andreas Eikemo, pairing with Hande Tugrul of Bocconi University, have published a chapter on social protection in the Handbook of Health Inequalities Across the Life Course. The chapter explores the pathways through which social protection policies can influence health, especially within a life-course perspective. It shows that policies that improve the conditions of the parents have a positive impact on children now and later in life, and can contribute to greater child health equality.
|
|
 |
|
Have stimulus packages mitigated the negative health impacts of COVID-related job losses?
Have COVID-19 stimulus packages mitigated potential harms to health from unemployment? A team of CHAIN researchers led by Dr Courtney McNamara conducted a systematic review of the health effects of job loss during the first year of the pandemic. It found that such programs limited the impact on food security and mental health. However, despite the implementation of large-scale stimulus packages to reduce economic harm, there were clear associations between job losses and negative impacts on health and wellbeing.
|
 |
|
What are the health consequences of informal employment among female workers and their children?
Informal work is an unprotected and unregistered form of work, often characterised by precarious working arrangement. Although it remains among the most common type of employment worldwide, little scholar attention has been directed to its impact on health, which are thought to be significant. A literature review conducted by a group of CHAIN researchers led by Amanda Aronsson, found an association with worse health outcomes, particularly on child nutritional status and antenatal health.
|
|
|
Access to and use of care
|
|
 |
|
Are patient navigation programmes effective in increasing participation to cancer screening?
Inequalities in cancer incidence and mortality can be partly explained by unequal access to health services such as cancer screening. Patient navigation (PN) is a type of intervention focusing on reducing barriers to care. A group of CHAIN researchers led by Dr Isabel Mosquera set out to identify the reported components of PN and to assess its effectiveness in promoting screening for breast, cervical and colorectal cancers.
|
 |
|
Does opposition from the far-right hinder vaccine programmes?
A group of CHAIN researchers led by Manuel Serrano-Alarcón has examined whether far-right politicians’ opposition to COVID-19 vaccination in Spain complicated vaccine roll-out. Analysing data from Spain’s monthly survey on political and social issues, the researchers found that far-right politicians can encourage vaccine hesitancy. However, public attitudes towards vaccination can be changed, and rapid and effective vaccine rollout can help overcome the resistance of far-right voters to get vaccinated.
|
|
|
|
|
