Cancer continues to be a leading cause of mortality and morbidity the world over. While the incidence of cancer is projected to increase by 70% over the next two decades, some research findings suggest a disproportionate distribution of new cancer cases and attendant fatalities across certain regions of the world, with poor and lower income countries worse affected at a time when advances in cancer research, medical technology, and drug development are giving rise to better cancer survival in developed countries. In this study, the role of selected social determinants of health in gauging cancer outcomes relative to incidence across various countries in different regions of the world was explored. The results indicated that the education index, income index, Gini coefficient, availability of cancer control policies and programs, as well as health system performance have an association with and are good predictors of the mortality to incidence ratio (MIR) of lung, breast, cervical, and colorectal cancers. In other words, populations with better education, higher incomes and lower inequalities, active cancer control policies and programs and high performing health systems have better cancer outcomes as reflected in lower MIRs relative to other populations.

BackgroundMaternal and infant mortality are highly devastating, yet, in many cases, preventable events for a community. The human development of a country is a strong predictor of maternal and infant mortality, reflecting the importance of socioeconomic factors in determinants of health. Previous research has shown that the Human Development Index (HDI) predicts infant mortality rate (IMR) and the maternal mortality ratio (MMR). Inequality has also been shown to be associated with worse health in certain populations. The main purpose of the present study was to determine the correlation and predictive power of the Inequality Adjusted Human Development Index (IHDI) as a measure of inequality with the Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), Early Neonatal Mortality Rate (ENMR), Late Neonatal Mortality Rate (LNMR), and the Post Neonatal Mortality Rate (PNMR).Methods and FindingsData for the present study were downloaded from two sources: infant and maternal mortality data were downloaded from the Global Burden of Disease 2013 Cause of Death Database and the Human Development Index (HDI) and Inequality-Adjusted Human Development Index (IHDI) data were downloaded from the United Nations Development Program (UNDP). Pearson correlation coefficients were estimated, following logarithmic transformations to the data, to examine the relationship between HDI and IHDI with MMR, IMR, ENMR, LNMR, and PNMR. Steiger’s Z test for the equality of two dependent correlations was utilized in order to determine whether the HDI or IHDI was more strongly associated with the outcome variables. Lastly, we constructed OLS regression models in order to determine the predictive power of the HDI and IHDI in terms of the MMR, IMR, ENMR, LNMR, and PNMR.Maternal and infant mortality were both strongly and negatively correlated with both HDI and IHDI; however, Steiger’s Z test for the equality of two dependent correlations revealed that IHDI was more strongly correlated than HDI with MMR (Z = 4.897, p < 0.001), IMR (Z = 2.524, p = 0.012), ENMR (Z = 2.936, p = 0.003), LNMR (Z = 2.272, p = 0.023), and PNMR (Z = 2.277, p = 0.023). Furthermore, side-by-side OLS regression models revealed that, when IHDI was used as the predictor variable instead of HDI, the R 2 value was 0.053 higher for MMR, 0.025 higher for IMR, 0.038 higher for ENMR, 0.029 higher for LNMR, and 0.026 higher for PNMR.ConclusionsEven when both the HDI and the IHDI correlate with the infant and maternal mortality rates, the IHDI is a better predictor for these two health indicators. Therefore, these results add more evidence that inequality is playing an important role in determining the health status of various populations in the world and more efforts should be put into programs to fight inequality.

This research sought to better understand female veterans' underutilization of veteran and military service organizations (VSO/MSOs). Specifically, the Service Women's Action Network (SWAN) conducted a needs assessment examining historically low levels of social cohesion among women veterans, and then a research team analyzed data for its statistical and practical significance. The intent of this research was to provide guidance about how best to develop organizational programming around the needs of military women. Secondary analysis of 2016 SWAN needs assessment survey data involved mixed-methods analysis of open-and closed-ended questions related to VSO/MSO participation and included frequency tables, geospatial analysis, multiple logistic regression analysis with educational achievement, race/ethnicity, service branch, and service era predicting participation. Quantitative analyses were followed by content analysis of questions that provided additional insight into the participants' perceptions of VSO/MSOs. Of the sample (n = 829) in the present study, 31.1% of respondents were members of one or more VSO/MSOs. Current members (n = 219, response rate 84.9%) identified three primary organizations in which they participated, including The American Legion (32%), Disabled American Veterans (28%), and the Veterans of Foreign Wars (28%). VSO membership differed somewhat by state, with participation highest in Maryland and Wisconsin. Regression models indicated that female veterans' participation in VSOs can be correlated to higher levels of education (OR = 1.66, 95% CI [1.04, 2.66]) and Hispanic/Latino ethnicity (OR = 2.60, 95% CI [1.07, 6.33]). Statistical significance was not found for predictor variables of service branch or service era, although greater proportions of respondents were Army (30.4%) and Post-9/11 (27.6%). Qualitative analyses indicated that respondents (n = 773) did not feel welcome in existing service member and veteran groups (25.23%). Respondents identified this as one reason they were not currently members of these types of organizations (29.75%). Study findings offer perspective regarding women veterans' participation in and perceptions of VSO/MSOs. The findings offer important feedback for organizations hoping to reach women veterans, the fastest growing veteran population. Recommendations for increasing participation include targeted programming, single-sex offerings, available child care at some events, tailored messaging with outreach initiatives, and peer support efforts.

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